Please fill out all necessary fields. Mail to: BandanaMan, PO Box 458, Crystal Bay NV 89402 or Fax to: (702) 869-8989
Please
Double Check Your Information!
25% of all orders contain wrong information, particularly E-mail addresses,
shipping address and wrong or incomplete credit card numbers.
*Designates Required Information
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*SHIP TO (No PO or APO boxes): *Full Name:_____________________________________________ Company:________________________________________________ *Address:_______________________________________________ _________________________________________________________ *City:__________________________________________________ *State/Province:________________________________________ *Zip/Postal Code:_________________ *Phone Day:_______________________________ Phone Night:________________________________ *Fax:__________________________________ *E-mail:_______________________________________________
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*BILLING ADDRESS (if different than shipping): Full Name:_____________________________________________ Company:________________________________________________ Address:_______________________________________________ _________________________________________________________ City:___________________________________________________ State/Province:________________________________________ Zip/Postal Code:_________________
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*METHOD
OF PAYMENT: Visa:_____ Mastercard:______ CC#___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ EX:___ ___ / ___ ___ Security code__ __ __ __ __ __ __ Money Order (Drawn
on US$ Funds):_____ |
*SHIPPING METHOD (Our standard shipping method is FedEx): FedEx Overnight:_____ FedEx 2nd Day:_____ FedEx 3rd Day:_____ FedEx Ground:_____ SPECIAL SHIPPING INSTRUCTIONS:_________________________________________ _________________________________________________________________________ |
| *PRODUCT
ORDER: (Enter Quantity by Dozens. Example: 50 = 50 dozen) |
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| OPEN CENTER | BLANKS | PAISLEYS | SPECIALTY |
| Black Square ______ Navy Blue Square______ Red Square ______ Black Circular_______ Red Circular ______ Navy Circular _______ White Circular______ |
Black______ Navy Blue______ Red______ White______ Yellow (Bright)______ Purple _______ Forest green ________ Orange _________ Lt. Blue _________ Royal Blue ________ Lt. Pink __________ Natural(Organic) ______ Gray ______ Cocoa Brown ______ Gold _______ |
Black______ Black, Red, White______ Burgundy______ Charcoal Gray______ Cocoa Brown______ Fuschia______ Gold______ Turquiose______ Hot Pink______ Hunter Green______ Lavender______ Light Blue______ Navy Blue______ Orange______ Pink______ Beige_______ Purple______ Red______ Royal Blue______ Silver______ White______ Yellow______ Blue Jean _______ Mirage Blue _______ |
B&W
Checkerboard______ Cowhide______ Wavy US Flag______ Multi Flag ________ Red Chili Peppers______ Red Rodeo Cowboy______ US Flag______ Tie-Dye Blue______ Tie-Dye Yellow______ Tie-Dye Paisley______ Tie-Dye Purple______ Tie-Dye Aqua______ Pirate Skulls______ Urban Camo______ Woodland Camo______ Pink Camo ________ Blue Camo ________ |
*Authorization
Signature:
__________________________________________________
(Necessary to begin processing of order. Must be signed by person authorized
to place this order).
*Print Authorization Name: _______________________________________________
*RN#, Fed Tax ID, 501C Designation (please specify):___________________________________________________
*Date: ___________________________
All orders are confirmed by BandanaMan within 24 hours (except weekends).
PLEASE DOUBLE CHECK ALL INFORMATION!