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Riders Through the Century Printable Order Form |
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| Name: | ______________________________________________________ |
| Street: | ______________________________________________________ |
| City, State, Zip | ______________________________________________________ |
| Phone: |
______________________________________________________ |
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Payment (Circle One): Check Credit card |
Amount enclosed: |
4 to 6 weeks for delivery. For Returns Authorization |
| Card type (Circle One): Visa MC | ||
| Expiration Date: | ||
| Acct #: | ||
| Signature: | ||
| DESCRIPTION | COLOR | QTY. | PRICE PER ITEM | TOTAL AMOUNT | |
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Make check payable to and mail to: Riders Through the Century P. O. Box 1005 Capitan, New Mexico 88316 Phone: 505.354.2086 E-Mail: Kerry@CharroCoats.com Website: http://www.CharroCoats.com |
Product Subtotal | ||||
| Shipping and Handling (add $20.00) | |||||
| IL residents add 6.25% | |||||
| TOTAL | |||||
| Thank you for your order! | |||||
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