ORDER FORM

COLOR OR PRINT SIZE

DESCRIPTION

 QUANTITY PRICE EACH TOTAL
 

     

SUBTOTAL
*  TEXAS RESIDENTS ADD 8.25% SALES TAX

*SALES TAX
**  SHIPPING AND HANDLING

IF TOTAL IS LESS THAN $50.00    ADD $7.50

**SHIPPING & HANDLING
   

IF TOTAL IS MORE THAN $50.00  ADD 15% OF TOTAL

GRAND TOTAL


NOTE:  Please make checks payable to "Alpha Omega Uniforms".
           No out of state checks please. There is a week delay of shipment for payment by check.

  BILLING INFORMATION     SHIPPING INFORMATION
NAME:   NAME:
ADDRESS:   ADDRESS:
     
PHONE:   PHONE:
FAX:   FAX:
EMAIL:   EMAIL:

 

  CREDIT CARD INFORMATION
NUMBER:   VISA   
EXPIRATION DATE:   MC   
CARDHOLDER NAME:   AMEX   
CARDHOLDER SIGNATURE:     DISC


      

 

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