(please print out this form - fill in all information requested and enclose with knives to be sharpened)

Customer Information:

Customer Name:_________________________________________

Return Shipping Address:__________________________________

                                          __________________________________

                                          ___________________________________

Daytime Phone:___________________________________________

Other Contact #:__________________________________________

Items Enclosed:

Number of Knives Enclosed:________________________________

Brief Description of Each: (ie: Brand Name, Type, etc.)

1.______________________________________________________

2.______________________________________________________

3.______________________________________________________

4.______________________________________________________

5.______________________________________________________

Please note once your request has been filled, one of our service representatives will contact you for payment information.

Thank you for your continued patronage,

The Northwestern Cutlery Staff

Ship To:

Northwestern Cutlery

810 W. Lake Street

Chicago IL, 60607

Attn: Sharpening