Print this form, then fill it out and fax it to : 1-858-653-3037
Or you can mail it with your check to :
ShirtChamp.com
Attn: sales Dept.
9225 Dowdy Dr. # 107
San Diego, CA. 92126


Ship To: Company Name:_______________________________________
Name: _________________________________________ PO#:_________
Address:______________________________________ APT: #________
City:____________________________ State:_____ Zip:_______ _____
Day Tel:_________________ Night Tel: _______________ FAX:_________
E-Mail:___________________________________ Date:___/__/___
Bill To: Company Name:_______________________________________
Name: _________________________________________ 
Address:______________________________________ APT: #________
City:____________________________ State:_____ Zip:_______ _____

Order information
             Shirt description                         Color         Size    Qty     Price     Total
1 __________________________  ________  ___  ___  _____  ____
2 __________________________  ________  ___  ___  _____  ____
3 __________________________  ________  ___  ___  _____  ____
4 __________________________  ________  ___  ___  _____  ____
5 __________________________  ________  ___  ___  _____  ____
6 __________________________  ________  ___  ___  _____  ____
7 __________________________  ________  ___  ___  _____  ____
8 __________________________  ________  ___  ___  _____  ____
9 __________________________  ________  ___  ___  _____  ____
10 _________________________  ________  ___  ___  _____  ____
11 _________________________  ________  ___  ___  _____  ____
12 _________________________  ________  ___  ___  _____  ____
13 _________________________  ________  ___  ___  _____  ____
14 _________________________  ________  ___  ___  _____  ____

15 _________________________  ________  ___  ___  _____  ____

Credit card Information                                                          Subtotal:________
Visa M/C A/E Discover                       (California residents only add) Sales Tax:________
credit card # _____ _____ _____ _____                      Shipping Charges:________
Expiry date: _____ _____

            Signature:___________________                                         Total:_______
Notes: ______________________________________________________________
____________________________________________________________________
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