Lofts Order Form – Lofts, Inc.

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About
Ordering
Contact

Home
About
Ordering
Contact

Lofts, LLC. Online Order Form

Fill-in the form on this page. When you click "SUBMIT" your information will be sent to Lofts, LLC personnel. You will receive a confirmation email when your payment is finalized. Note that fields marked with * are required.

Student/Dorm Information

Student First & Last Name*

Room Assignment Received?*

Yes

Dorm*

Arrival Date*

Enter your actual move-in date. Your loft bed will be installed prior to your move-in date.

Student's Cell

Student's Email

Room Number*

Contact Information

Contact First & Last Name*

Address*

City*

Daytime Phone*

Email address*

Order confirmation will be sent to this address

Address Line 2

State*

Zip Code*

Alternate Phone

Loft Bed Information

Prices include installation & tax

Purchase Item(s)

Loft bed ($219.35)

Safety Rail ($58.58)

Ladder ($90.95)

Select all the items you would like to purchase

No dorm assignment yet.

Light Loft Bed*

Dark Loft Bed*

Residence Halls 1, 2, & 3

Optional Add-Ons

Safety Rail ($58.85)

Ladder ($90.95)

Order Agreement

By checking the box below, the parent or guardian of the student understands and agrees with the Lofts, LLC, Terms & Conditions.

For Parent/Guardian*

Yes, the parent/guardian understands

By checking the box below the student, understands and agrees with the Lofts, LLC, Terms & Conditions.

For Student*

Yes, the student understands

Payment Information

Your transaction does not process automatically. We will manually input your order once it is received.

Method of payment*

Visa

MasterCard

Amex

Name on card*

Credit card number*

CVS code*

Three- or four-digit value printed on the front of the card or on the signature strip on the back

Exp. Month*

Year*

Billing Address is*

Same as Contact Information

Different from Contact Information

Billing Address*

Billing Address2

City*

State*

Zip Code*

Comments or Special Requests

Type the characters*

This field should be left blank

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