Bill to
Same )_________________________________________
Customer Name
_________________________________________
Customer Name
Address
Address
City, State, Zip
City, State, Zip
Phone
Phone
|
Sports Village Order Form
|
| toll free 1.877.490.4990 |
Monument Mall Suite 106
|
| fx 1.308.635.3650 |
Scottsbluff, NE 69361
|
|
Bill to |
|
Ship to (
Same ) |
_________________________________________ Customer Name |
_________________________________________ Customer Name |
|
| _________________________________________ Address |
_________________________________________ Address |
|
| _________________________________________ City, State, Zip |
_________________________________________ City, State, Zip |
|
| _________________________________________ Phone |
_________________________________________ Phone |
|
Style#
|
Description
|
Size
|
Quantity |
Retail
|
Total Price
|
|
Merchandise Total
|
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|
Shipping/Mailing Amount
|
|||||||
|
(NE only) Sales Tax
|
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|
Total Payment Due
|
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 |
 |
 |