TeamTailgateShop.com

Celebrate the ultimate American tradition!

2531-A Meadowview Lane

Pelham, AL 35124

Phone 888-312-0648  Fax 800-342-8914

FAX ORDER FORM

1 800 342 8914

billing address:

Name :  ___________________________________

Address: __________________________________

Address:___________________________________

City:  ____________________  ST ____ ZIP _____

Daytime Telephone No.:

Email Address:

Note – a valid email address is needed to send you a tracking number. Your email and contact information will not be sold to third parties!

Ship To:

Name :  ___________________________________

Address: __________________________________

Address:___________________________________

City:  _____________________  ST ____ ZIP _____

Daytime Telephone No.:

Email Address:

Note – a valid email address is needed to send you a tracking number. Your email and contact information will not be sold to third parties!

ITEM NO.

QUANTITY

DESCRIPTION

ITEM PRICE

TOTAL

1.     Check that the billing & shipping addresses are correct

2.     Enter your credit card information below:

____ ____ ____ ____ ____ ____ ____ ____ ____

­­­Credit Card Number (please write clearly)

Expiration Date _______________________ (MM/YYYY)

CVV (security Code) ___________________  (3 or 4 digit code)

__________________________________________________________________

Authorized Signature                                                                         Date

SUBTOTAL

SALES TAX (alabama Residents only)

GIFT WRAP ($4.95)

TOTAL