Specialty Order Form

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SPECIALTY ORDER FORM
FOR WAREHOUSE USE ONLY: DO NOT FILL
Customer Name:
Phone Number:
Order taken by:
Date:
Shipping Method:
Email:
Credit Card:
Ship to Address:
Exp Date & CVC:
Product
Product Name
Type
Size
Color
Qty
Customization
Number
(home, away, other)
NAME
NUMBER
(max 10 letters)
(max 2) back/front
Special Order Instructions:
Disclaimer and Instructions: Pack the item(s) securely in the original package, if possible. For your protection, we recommend that you use UPS
or Insured Parcel Post to send your items to us. We cannot accept C.O.D. deliveries. is not responsible if your package is lost or
damaged while in transit to our warehouse. Keep your tracking number from the package you are sending to ensure that the package is
returned to our warehouse. Once we received your package, we will contact you to request your credit card information. Upon confirmation of
payment, we will process your order. Cost for customization: $12.50 – Name, $12.50 Number(s) front and back, plus shipping.
PLEASE SHIP JERSEY(S) TO:
ATTN: CUSTOMIZATION DEPT
TH
1632 240
STREET
HARBOR CITY, CA 90710

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