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Customer Information

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Account Information

Date

Name

Organization

Phone Number

E-mail

Fax

Address

 

BusinessResidence

City

State

Zip

Referred By

Who is your billing contact person?
Club or TreasureAth Dir &/or SecrCorp A/P

Funds will come from
Business/SchoolPrivate/Booster

Method to payment

Final Payment

(check/credit card/purchase order) Payment in full Prior to shipping. If less than 6-8 weeks production must put in full payment for order to be in production.

P.O. (schools Only) Will Payment be released prior to receiving final/finished product?
YesNo


BILLING INFO

Same ad aboveDiffrent as aboveBusinessResidence

Contact Name

Comapny

Address

City

State

Zip

Home#

Cell#

Work#

Email

Fax

SHIPPING INFO

Same ad aboveDiffrent as aboveBusinessResidence

Contact Name

Comapny

Address

City

State

Zip

Home#

Cell#

Work#

Email

Fax


Customer Question

How Many squads/teams does your location have?

Many Athletes?

Over all Budget?

Products you are interested in?

Briefly describe your experience with other suppliers/What would you like to see done Differently?