Place an Order

Complete the form below to place an order with Cubicle Curtain Factory by paying via Credit Card. You must have either your estimate number or your invoice number. You can also click here to complete our credit card form online and either email or fax it to us at 866-804-5692 or email it to sales@cubiclecurtainfactory.com.

We appreciate your business and value you as a customer!

Company Name on Order

Contact Name

First Name

Last Name

Email Address for Paid Invoice

A copy of your paid invoice will be sent to this email.

Order Number

Correctly enter either your estimate or invoice number below.

Promo Code

If you've received a promo code that you'd like to be added to this order, please enter it here.

Total on Order Approved for Credit Card Processing

Please enter dollars and cents in U.S. currency as stated on order.

Name on Credit Card

Enter clearly the full first line of the name on the credit card listed to process payment.

First Name

Last Name

Credit Card Number

Enter the full card number listed on the credit card. This information will be destroyed after payment has been processed.

Expiration Date

Enter the expiration date of the credit card to be used to process this order.

Security Code (CVV)

3 Digit code on back of card. 4 Digits on front next to card number for American Express.

Billing Address

Address where the credit card statements are sent.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Shipping Address

Confirm the address where the order is to be shipped. This will be compared and verified with the shipping address given at the time of the order request.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Order Processing Verification and Approval

Required in order to process payment. Please enter the name of the representative authorizing the payment of this order.

Final Authorization: I hereby confirm I am human and hereby authorize Cubicle Curtain Factory to process the credit card I have listed above to process payment on the order I have listed above for the amount I have confirmed above. I understand that my personal information is being sent over the Internet and release Cubicle Curtain Factory from any liability of identity or credit card theft that may result from doing so. I understand Cubicle Curtain Factory will not distribute my personal information and will use it solely to process an order I have willingly placed and, after processing payment, will destroy my personal information immediately following a successful payment receipt. By digitally signing below, I agree to the above authorization and statements.