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Please complete this form to order your merchandise.
| Name | |
| Address | |
| City/State/Zip | |
| Home Phone | |
| Work Phone | |
| E-mail Address |
Please provide the following ordering information:
|
QUAN. |
STOCK No. |
DESCRIPTION | FONT | TEXT |
COST |
EXT. |
Shipping and handling charges will be added to each order. Sales tax will be added to orders for Ohio residents.
Please provide the following payment information:
| BILLING | |
Type of Credit Card |
|
| Cardholder's Name | |
| Credit Card Number | |
| Expiration Date - MM/YY | / |
| Last 3 Digits in Signature Panel |
Since we ship by UPS, please provide the following shipping information. We must have a street address for delivery. Please allow 2 weeks for processing.
| SHIP TO: | |
|
Name |
|
| Street Address | |
| Address (cont.) | |
| City | |
| State/Province | |
| Zip/Postal Code | |
| Country |