Spokiz Team Order Sheet

Fill out online, Print/Save as PDF and

email to kate@jlracing.com

ORDER INFORMATION:
Team Name:
Contact Name:
  OUR CARRIERS WILL NOT DELIVER TO A PO BOX, PLEASE PROVIDE A STREET ADDRESS
Shipping Address:
City:
State:
Zip/Postal Code:
Country:
Email:
Phone:
Fax:
Date Submitted (MM/DD/YR):
Date Needed (MM/DD/YR):
  email or call if you have extensive comments
Notes:
PAYMENT INFORMATION: Before production begins on your order we need one of the following: prepayment, deposit (balance is due before order is shipped).
prepay deposit
* CC (Pay in full) CC (Hold for Check)
*Exp:
*CC#:
*3-digit "card code":
found on the back of card, last 3 digits of code printed inside of signature strip
*First line of billing address
*Zip of billing address:
*Cardholder Name:
Cardholder's Signature:

 

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Describe your Team Spokiz: Type text to be printed on band, 21 Character Limit!

Frame and Lense Color can be chosen on an individual basis--each person can choose a different combo! Once you submit this form, you will receive an individual order form for this information.

Details of your Spokiz
Nipple Color Band Color

Custom Color Requested

Notes: