Mirror Frame Design Request Form

Mirror Frame Design Request Form Frames are custom built to your mirror outside & clearance dimensions Complete and submit this form as you place an order, or for a quote.
Name
Prefix
First
Last
Suffix
Your Street Address
Your City
Your State (USA) and Zip
Email *
Phone *	### - ### - ####
Mirror Frame Style *	Please Select a Frame Design Medford 2" Frame Chelsea 2 1/2" Frame Belmont 3" Frame Grant 3" Frame Troy 3" Frame Clifton 3" Frame Durham 3" Frame Wakefield 3" Frame Anderson 3" Frame w Shelf Marion 4" Frame w Shelf Lodge Western Red Cedar 3" Frame Cottage Rustic Pine 3" Frame
Frame Cap/Cornice? *	No Thanks Maysville Cap (no keystone) Piedmont Cap (keystone) Roanoke Cap (keystone & dentil)
Side Shelves?	No Thanks Yes, add four side shelves
Frame Finish Color *	Please Select a Finish Color Semi-Gloss White Matte Black Golden Honey Tuscan Coffee Merlot
Enter Overall Mirror Width *	Outside Left-to-Right Dimensions in inches
Enter Overall Mirror Height *	Outside Dimensions Top-to-Bottom in inches
Clearance Above Top *	Clearance from top of mirror to light, ceiling, etc.
Clearance Below Mirror *	Clearance from bottom to backsplash, outlet, counter, etc.
Clearance to Left of Mirror *	Clearance from Mirror to wall, light switch, outlet, etc.
Clearance to Right of Mirror *	Clearance from Mirror to wall, light switch, outlet, etc. NOTE: Mirror Clips measuring more than 3/16" depth above from mirror face may need to be replaced!
Do you have mirror clips? *	Yes, I have mirror clips   No, I do not have mirror clips    Depending upon the clearances you list and whether you have mirror clips, we may adjust the outside dimensions of your frame.
Add a note for us ...	Give us any additional information you think is necessary. Email photos, if desired, to customerservice@mantelcraft.com www.mantelcraft.com Phone (800) 820-7177 Fax (256) 767-2916