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       PLACE ORDER __________________________________________________________________________

 - To place an order just fill out the information below and hit submit.  Your order will be emailed to us, and we will call or email you back to confirm that we received it.

  -  When ordering please be sure to include color, size run and how many cases you would like to order. On open stock styles please be specific.

  -  If you would prefer to order by phone please call 1-888-320-0634
BILLING ADDRESS
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(BOLD indicates a required filed)

             

               First Name                     

               Last Name                     

               Address 1                      

              (Apt, Suite, Company   

                                      Name)

               City                                

               State                              

               Zip Code                       

              Billing Phone                

              Daytime Phone             

              Email Address               

 

This billing information needs to match what is on record with your credit card issuer.

The Billing Phone number needs to match the phone number on record on your credit card statement.

The Daytime Phone number is required in case we need to contact you regarding your order.

An Email Address is required so that we may email you regarding the status of your order.
   
 BILLING AND SHIPPING ADDRESS THE SAME?                                

yes no                                 

   If you selected "YES" you won't need to fill out the shipping address  in the shipping information section below. 
   
SHIPPING INFORMATION กก

               First Name                     

               Last Name                     

               Address 1                      

              (Apt, Suite, Company   

                                      Name)

               City                                

               State                              

               Zip Code                       

              Daytime Phone              

 
       SHIPPING METHOD

       GROUND EXPRESS SERVICE

  PAYMENT METHOD ( NEW CUSTOMERS NEED TO USE PREPAY)

   PRE-PAY / CREDIT CARD 

   PRE-PAY / CASHIER CK OR MONEY ORDER

   COD-CASH

   COD-CO. CHECK

   NET 30
   
ORDER FORM 
     ITEM           SIZE                    QTY (CASES)    COLOR            
             

                

             

             

             

             

             

             

             

             

               

               

 

 

 
   

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