845 Prosper Road De Pere, WI 54115 Toll Free: 1-800-236-8981 Fax: 1-920-336-5956 Email: [email protected] Website: www.valleycustomdoor.com Customer # : DRAWER BOX ORDER FORM Phone: Company Name: Fax/Email: Mailing Address: P.O. # Shipping Address: Job Name: City/State/Zip: Preferred Shipper: Date: Side Thickness 5/8" Bottom Panel Material 1/4" Select White Oak Select White Ash Select Walnut Select Hickory Select Clear Pine Select Birch Select Cherry Select Hard Maple Select Red Oak Drawer Box Sizes Note: On Bottom Mount applications, the height of box should be ordered without the bottom panel dimension included. Qty 1 1/2" na na na na 2 Notes: No Bottom Bottom Panel Application Are these boxes to be shipped with a door order? Do you want the boxes shipped before the doors if possible? Premium Grade Cherry (Standard) Place an "X" in the appropriate box within each group. Red Oak (Standard) Dovetail Drawer Box Construction Birch (Standard) Standard Grade 3 Inset 1/4" 4 Inset 3/8" 5 Inset 1/2" 6 Other: _________ 7 Bottom Mount 8 Notes: YES NO 9 Assembled 10 Options Finished 11 Scoop Front 12 Pullout Front 13 Notch Width: ___1-3/8" (Standard 33mm) Under Notch 14 Other: 15 12" 14" 16" 18" 20" Drawer Tracks Full Ext. (side mount) 22" 16 17 Mounting Brackets (pair) 18 3/4" Ext. 9" 12" 15" 18" 21" 19 Blum™ Tandem 20 Blum™ Motion N.A. 21 Rear Mounting Brackets Notes (pair) 22 23 24 Width Depth Height Note/Add Option