The Shandrew Company • P. O. Box 836 Hurst, Texas • 817-791-6626

Order Form

Please Print

First Name: __________________________ Last Name: __________________________

Billing Address: ___________________________________________________________

City: ___________________ State: ______ Zip Code:___________

Daytime Phone: (____)______________ Evening Phone: (____)______________

Email: ___________________________________________

Check here if Billing and Shipping Adress are the same: _______

Shipping Address: ___________________________________________________________

City: ___________________ State: ______ Zip Code:___________

Please Complete ALL fields

Truck Make ___________________ Truck Model ___________________

Truck Year ___________________

Truck Bed Width ___________________ Truck Bed Depth ___________________

Does your truck have a bedliner? ___________________

* CargoCatch™ Sizes: Medium or Monster

If you need a custom made unit, please call us at 817-791-6626 or
email us at customerservice@mycargonets.com

Select Method of Payment: Check/Money Order _____ VISA _____ MasterCard _____ Discover _____

Credit Card Number: _____________________________________ Expiration Date: _____________

CVV: ______________

The CVV number is the last 3 digits on the Signature Panel on the back of the card.

Cardholder Signature: _______________________________________ Date: ______________________

Promotional Code: ________________

Please make checks and money orders out to The Shandrew Company and

send payment along with completed order form to:

The Shandrew Company
P. O. Box 836
Hurst, Texas 76053

Please allow 7 to 10 business days to allow personal checks to clear before your order is processed.