Lofts, LLC   - Loft Bed Rental 2008/2009

 

 P.O. Box 1297    Batesville, MS 38606   Ph:  662-561-1050  Fax: 662-561-1030   

                          e-mail:  lofts@cableone.net

 

 

 

Date:_____________________

                                                                                                     

Student Name:____________________________    Hall Name:______________    Room #:____________

 

Home Phone:___________________Cell Phone:___________________Hall Phone:__________________

 

Home Street Address/PO Box:____________________________________________________________

 

Home City:___________________________________ State:______________ Zip:_______________

 

 E-mail Address:__________________________________ (Order confirmation will be e-mailed to this address)

 

Payment Method:                 ____Check/Money Order   - Mail Check or Money Order to PO Box 1297 Batesville, MS  38606

 

 ______ Visa    ______Master Card  ______American Express    Credit Card Order may be faxed to 662-561-1030

                  

 

Credit Card #______________________________________________Expiration Date:_______________

 

Name as it appears on Credit Card__________________________________________________________

 

Credit Card Billing Address/City/State/Zip:  ___________________________________________________

 

Parent’s Signature:_______________________ Student’s Signature:_______________________________

 Your signature above indicates that you have read and agree to the terms  and conditions

of the loft bed rental as stated on the reverse side of this order form .

Please place a check mark in the appropriate box below to indicate which loft bed you wish to order

Loft beds are installed at a standard height of 60 1/2” from the floor to the bottom of the bed spring.  Loft beds can be lowered at your request in 3” increments.  If you would like for your loft bed to be lowered, please indicate below. 

 

Please lower my loft bed by:

 

________3”         ________6”     ________9”     _______12”

All loft beds will be installed by August 20, 2008.  If you will be moving into the residence hall prior to August 20, 2008 ,  and would like to have your loft bed

 installed early, please indicate your arrival date below.

 

Early Arrival Date:_________________

ORDERS MUST BE RECEIVED NO LATER THAN JULY 1, 2008

 IN ORDER TO GUARANTEE INSTALLATION PRIOR TO AUGUST 20, 2008.