Order Form

Please fill in all information that applies and click on the print button at the bottom of this page and fax (630-627-2232) or mail in your order to Mr. Shims, P.O. Box 1062, Addison, IL 60101. Alternatively, you may call us directly at (800) 72-SHIMS and a representitive will be happy to take your order.

Ordering Information
Please note: required information is in RED^*
Note: An address or optional shipping address is required.

Full Name*:
Address:
City:
State/Prov:
ZIP/Postal Code:
Country:
Telephone*:
Email*:

Optional Shipping Instructions,
if different from above:

Ship To:
Shipping Address:
Shipping Instructions:

Product Selections
Payment Information

Select Payment Method* (required)	Credit Card Check Money Order
Credit Card Information Type of Card:     Master Card       Visa       None Name on Card: Card Number: Expiration Date:

If you are ordering by mail or fax print this form and send it to us.
Otherwise click the "Send Order" button below to finalize your order.

Make checks payable to:

Mr. Shims P.O. Box 1062 Addison, IL 60101 Phone: (800) 72-SHIMS Fax: (630) 627-2232