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Product Order Page

Name:
Address:
City/State/Zip:
E-Mail:
Phone:
Please refer to the item page for available sizes and prices
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Description
Quantity
Size
Price Each
Embroidery
Embroidery Fee
$1.00 per character
Total Price
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Sub Total:
     
New York residents add
7% Sales tax:
     
S & H Via priority Mail $2.00 per Item
Shipping:
     
Merchandise
Total:
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Method of Payment:
_____Check
____Visa
____MC

Credit card Number:_____________________ Expiration date:__________________

Name as it appears on Master Card or Visa:_______________________________________

Authorized Signature:_________________________________________________________

Please Note...If you wish to pay by Credit Card or Check you should print this page before submitting the above item information. Card information is NOT transmitted via this form. Please call 518.756.3649 or mail this printed Order Form to

245 Starr Road * Ravena, NY 12143

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