Print this form, then fill it out and fax it to :
1-858-653-3037
Or you can mail it with your check to :
ShirtChamp.com
Attn: sales Dept.
9225 Dowdy Dr. # 107
San Diego, CA. 92126
Ship To: Company
Name:_______________________________________
Name: _________________________________________ PO#:_________
Address:______________________________________ APT: #________
City:____________________________ State:_____ Zip:_______ _____
Day Tel:_________________ Night Tel: _______________ FAX:_________
E-Mail:___________________________________ Date:___/__/___
Bill To: Company
Name:_______________________________________
Name: _________________________________________
Address:______________________________________ APT: #________
City:____________________________ State:_____ Zip:_______ _____
Order information
Shirt description
Color Size Qty
Price Total
1 __________________________ ________ ___ ___ _____
____
2 __________________________ ________ ___ ___ _____
____
3 __________________________ ________ ___ ___ _____
____
4 __________________________ ________ ___ ___ _____
____
5 __________________________ ________ ___ ___ _____
____
6 __________________________ ________ ___ ___ _____
____
7 __________________________ ________ ___ ___ _____
____
8 __________________________ ________ ___ ___ _____
____
9 __________________________ ________ ___ ___ _____
____
10 _________________________ ________ ___ ___ _____
____
11 _________________________ ________ ___ ___ _____
____
12 _________________________ ________ ___ ___ _____
____
13 _________________________ ________ ___ ___ _____
____
14 _________________________ ________ ___ ___ _____
____
15 _________________________ ________ ___ ___ _____
____
Credit card Information
Subtotal:________
Visa M/C A/E Discover
(California residents only add)
Sales Tax:________
credit card # _____ _____ _____
_____
Shipping Charges:________
Expiry date: _____ _____
Signature:___________________
Total:_______
Notes: ______________________________________________________________
____________________________________________________________________
____________________________________________________________________