CONFERENCE SUPPLY CENTER ORDER FORM

ITEM / DESCRIPTION / SIZE / AVAILABLE / CONFERENCE
COST / QUANTITY
ORDERED
Emergency Blanket / Foil; 59x80 / Twin / IN STOCK / $0.50
Blanket / Blue, 100% polyester blend, washable (Can be used on Twin or Full - 66x90) - Quantities limited / Full/Twin / IN STOCK / FREE
Blanket / Tan, 100% acrylic needle woven blanket
(Can be used on Twin or Full - 72x90) / Full/Twin / IN STOCK / $4.80
Towel / 100% cotton, assorted colors / 24x48 / IN STOCK / $1.50
Twin/Single Bed Frame / Black, metal, will not harbor bed bugs
Packed in cardboard carton 40” x 40” x 6”, 25 lbs. / Twin/Single / IN STOCK / $21
Bunk Bed Twin & Full / Black, metal, will not harbor bed bugs
Single/Twin on top, Full/Double on bottom
(Two persons can sleep on full bottom bunk.
One person on single top bunk.)
Packed in cardboard carton 75” x 58” x 6”, 85 lbs / Twin top
Full bottom / IN STOCK / $52
Twin/Single Futon Mattress / 6’’ thick with cotton cover, requires no inner spring.
Packed in plastic bag. For Twin/Single bed. / Twin/Single / IN STOCK / $21
Full/Double Futon Mattress / 8’’ thick with cotton cover, requires no inner spring.
Packed in plastic bag. For Full/Double bed. / Full/Double / IN STOCK / $28
Full/Double Bed Frame / Black metal, folding, won’t harbor bed bugs. Platform bed, no headboard or footboard. Uses full/double futon mattress. Packed in cardboard carton 54”x38”x3.5”. 35 lbs. / Full/Double / IN STOCK / $35
Sweat Shirt / Hooded, cotton, assorted colors / Youth M – L / IN STOCK / $3.00
Sweat Shirt / Hooded, cotton, assorted colors / Adult
M - 3XL / IN STOCK / $3.50
Hat / Knit wool blend, assorted colors / Fits All / IN STOCK / $0.50
Gloves / Cotton, elastic wrist band, 1 pair / Fits All / IN STOCK / $0.50
Socks / Pack of 6 pairs, crew length, white / Shoe size
6 - 12 / IN STOCK / $3.00/pack
Computer / Refurbished Windows Laptop, with Microsoft Office. Includes power cord. Client needs internet service (wired or wi-fi – at home, library, or places with free internet service) / NA / IN STOCK / $75.00
Delivery / Any number of items delivered to one address, one time, not assembled, not installed, ground floor only. / Not Discounted / AVAILABLE / $50
(per address)
Diapers / Package of 36 diapers for Newborns (under 10 lbs). / Newborn / IN STOCK / $3.75
Diapers / Package of 44 diapers, for 8-14 lbs / Size 1 / IN STOCK / $4.75
Diapers / Package of 84 diapers, for 12-18 lbs / Size 2 / IN STOCK / $8.70
Diapers / Package of 56 diapers, for 16-28 lbs. / Size 3 / IN STOCK / $6.75
Diapers / Package of 40 diapers, for 22-37 lbs. / Size 4 / IN STOCK / $5.25
Diapers / Package of 80 diapers, for 27+ lbs / Size 5 / IN STOCK / $13.00
Diapers / Package of 72 diapers, for 35+ lbs / Size 6 / IN STOCK / $13.00
E-mail completed form to: Conference will be billed. CSC address: 5301 Grant Ave., Door 6, Cuyahoga Heights, OH 44125. By appointment only. / TOTAL: / $

Circle One: Pick-Up by Client - Pick-Up by Conference - Delivery Requested PICK-UP/DELIVERY DATE: ______

Conference: ______Authorized by: ______Phone/Email: ______

Pick up/Delivery Contact: ______Phone: ______

Client Name: ______Phone: ______

Client Address: ______City: ______

Conference Supply Center Use Only:

APPROVED by Central Office:______Date: ______

I have received above items (PRINT): ______Signature: ______

Loaded by (CSC):______CSC #: ______

Updated September, 2017