ROMAN BLIND ORDER FORM Company COMPANY NAME CONTACT NUMBER DATE CONTACT PERSON ORDER REFERENCE/ ACCOUNT TYPE OF ROMAN BLIND FABRIC COLOUR LINING (TYPE & COLOUR) TRIM HEADBOARD (MM) ACORN CHROME BRASS WOODEN CLEAT CHROME BRASS CLEAR CLEAT CHAIN WHITE BLACK BIRCH WHITE METAL STAINLESS STEEL MOTOR ACMEDA WIRE FREE SOMFY WIRED IN ROMAN BLIND INFORMATION FOR EACH ROOM BLIND 1 Pin Width (mm) Drop (mm) Control Side Right or Left R L Room Name BLIND 2 Pin Width (mm) Drop (mm) Control R or L R L Room Name BLIND 3 Pin Width (mm) Drop (mm) Control R or L R L Room Name BLIND 4 Pin Width (mm) Drop (mm) Control R or L R L Room Name BLIND 5 Pin Width (mm) Drop (mm) Control R or L R L Room Name BLIND 6 Pin Width (mm) Drop (mm) Control R or L R L Room Name BLIND 7 Pin Width (mm) Drop (mm) Control R or L R L Room Name BLIND 8 Pin Width (mm) Drop (mm) Control R or L R L Room Name NOTES PICK UP YES NO DELIVERY TO SHOP Within 25km of Mulgrave YES NO
