Atkinson Electric LLC
Wallplate Division
P.O. Box 172
West Green, GA 31567
PH. 912.384.9773
Fax 912.384.6857
www.woodwallplates.com

Phone

Date
PO#
Job Name
Mastercard Visa Discover American Express
Card #
Expiration Date Security Code

Edge

Screw Color

Name and Shipping Address: (Priority Mail)

Credit Card Billing Address:

Quantity Item Description Material Unit Price Total Price

Shipping & Handling(inside the U.S)

Flat Plates $9 Per Order. Shipping price on Log Wall Plates will be $9.00 minimum but can vary based on weight.

Insurance(if desired, inside the U.S)

Order Total: