ROLLER POST® Order Form
Please print out this form, complete it and mail along with your check to:

   Nautical Concepts, Inc.
P.O. Box 1925  
Melrose Park, Illinois  60161-1925

 
   Name: _________________________________________  Date: _________ 

Address: _______________________________________________________

      City: ______________________________   State: _____    Zip: _________

   Phone: _________________________   Fax: _________________________

    Email: _____________________________________

 

 Shipping & Handling charges are for Continental U.S.A.

    [ ] 38"- $129 + $11.95 S&H    [ ] 48"- $145 + $13.95 S&H    [ ] 60"- $160 + $15.95 S&H
    

      No. of Rollers ______   Size: _______
Bracket Type
[ ] Square/Rectangular [ ] Round Posts/Pilings

ROLLER POSTŪ  for Round Post/ Pilings priced slightly higher.   Call for Pricing

     [ ]  Personal Check Enclosed        Signature: ___________________________