Great American Collectibles

Great American Fax Order Form
Print, fill out and fax to 503-218-8994

If you're ordering a custom Booster, please tell us the two main colors of the school or organization (or just any two colors you like) and what you want painted on the flag. Please write clearly.

Character Name Qty Price

_____________________ ____ _____

                                            Sub-Total:   ______

                Subtract Applicable Discounts:   ______

                                       Add Shipping:   ______

                                                   Total:   ______

Volume Discounts

    Total (Calculated before shipping):

         $0         - $66    = No Discount
         $66.01   - $110 = 5% Discount
         $110.01 - $180 = 10% Discount
         $180.01 +         = 15% Discount

Shipping: Include $6 for the first item + $1 for each additional item up to a maximum of $12.

Ship To Information:

Name: ___________________________________

Address: _________________________________

City: ________________ State: ____ Zip: ______

Country: _________________________________

Phone: __________________________________

Email: ___________________________________

Bill To Information:

Name on Credit Card: ______________________

Billing Address: ___________________________

___________________________

City: _______________ State: ____ Zip: _______

Credit Card #: _____________________________

Expiration Date: _____ / _______

By signing below, I am authorizing Great American Holiday Collectibles Co. to debit my credit card for the goods that have been indicated on this form. I have read the shipping charges and agree to be charged accordingly.

Signature of Card Holder:

__________________________ Date: _________

Comments:
_________________________________________

_________________________________________

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