Print this order form from the "print" option in your web
browser, fill it out, and Fax/mail with your credit card/check info to:
Date: _____/_____/_____
CUSTOMER INFORMATION:
Name: __________________________________
E-Mail Address: _______________
Address: ______________________________________________________
Daytime Phone Number: ( ___ ) - __________________
City:___________________ State/Prov.:_________ Country:_____ Postal Code/Zip:________
Model/Make of Vehicle:________________________ How did you find our site? ___________
______________________________________________________________________
ORDER INFORMATION:
| Description | Price | Quantity | Total |
Personalized Plate |
$5.00/plate |
||
Shipping & Handling |
$6.00 | ||
Total of Order |
|||
Personalized Plate Letters: _________________________ *Don't
Forget to add $5/plate for personalizing...
(up to 11 characters each plate)
PAYMENT INFORMATION:
___Visa ___MC
Name on card:____________________________________
Card #__________________________________ Expiration Date:____/____
Card Holder Signature:______________________________
______________________________________________________________________________
Thank you very much For Your Order