ORDER FORM

Customer:__________________________________

Shipping Address:
______________________________________
 City:____________________ State:_____ Zip:_________
Billing Address:
______________________________________
 City:____________________ State:_____ Zip:_________
Telephone:______________________ Evening:______________________ E-mail:___________________________
Quantity Description Catalog # Size Price Amount
           
           
           
           
           
           
           
           
           
           
Note: There will be a 15% restocking fee on all returns.

Payment Method (circle one): CHECK MASTERCARD VISA

Name On Card:___________________________________________

Credit Card Number:________  ________  ________  ________

Expiration Date:________/________

Authorizing Signature:________________________________

 XXL add $3.00/item ___________

XXXL add $4.00/item ___________

Sub-Total__________

Applicable Tax__________

Packing and Shipping         $10.00

TOTAL __________

To Order: Fax (240) 396-6826
 Email wwray@soccer-referee.com
 Mail: SPORTS, Etc. 9222 E. Parkhill Drive, Bethesda, MD 20814

Thanks for your business!