New Colors Added!
Date Ordered *
MM
/
DD
/
YYYY
Dealer Name *
Your answer
Contact Name *
Your answer
Email Address
Your answer
Dealer Shipping Address
Your answer
Job or PO Number *
Your answer
Is this a Rush Order? *
A rush order is one that is delivered in one week. Please note that an additional 10% fee will be added to any rush order. Not all orders can be rushed. If a rush order is requested, a Carstin Customer Service representative will contact you to confirm your order.
Is this a Remake? *
Wall Package
SWP / TWP
Your answer
Wall Package Color
Wall Package Finish
Shower Base
SB
Your answer
Shower Base Color
Shower Base Finish
Shower Base Package
SBP
Your answer
Shower Base Package Color
Shower Base Package Finish
Tiled Packages
SWPT / TWPT / SBPT
Your answer
Tile Package Color
Tiled Packages Pattern
Accessories
Item 1
Please specify item, quantity and color name/number/finish.
Your answer
Item 2
Please specify item, quantity and color name/number/finish.
Your answer
Item 3
Please specify item, quantity and color name/number/finish.
Your answer
Tub
Mark Number
Your answer
Size
Your answer
Tub Color
Tub Finish
w/HydraBath Whirlpool
Tub Only
Drain Location
Trim Set: Color
If "Other" is selected, please specify in the Additional Comments/Instructions space below.
Miscellaneous Items
Please specify if you would like Grab Bars, In Line Heaters, or Extra Jets. If so, indicate quantity.
Your answer
Additional Comments/Instructions
Tub will be drilled for overflow unless indicated otherwise.
Your answer
Customer Authorization Signature
Carstin Brands is not liable for any deviations from this order form. By signing and submitting this form, you are authorizing the above order to be processed. *
Your answer
Dealer Account Number *
If valid account number is not provided, this order will not be processed.
Your answer
Order Confirmation
You will receive an order confirmation within 48 hours. An approximate ship date will be assigned at this time. Please contact Customer Service at the number below if there are any inaccuracies in your confirmation, or if you do not receive an order confirmation within 48 hours.
Questions? Contact Us:
P.O Box 285
520 E. 2nd St. Arthur, IL 61911
Ph: (217) 693-6466 / Fax: (217) 543-3377
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