Please
print & fill out this order form. Fax it, if paying by credit card,
to our Toll Free FAX Order Line (800)227-3099. If paying by check
or M.O., please mail this form along with your payment to: THE
SUBMARINE SHIP'S STORE, 301 Whitworth Drive, Culpeper, VA 22701. Allow
4-6 weeks for delivery. PLEASE remember to
give
us your email address and/or daytime telephone number in case there is
a question about your order. We DO NOT distribute this information!
ORDERS SHIPPED TO OTHER THAN
A USPS ZIP CODE WILL BE CHARGED ACTUAL SHIPPING CHARGES.
| CREDIT CARD BILLING ADDRESS: |
MERCHANDISE SHIP TO ADDRESS: (IF DIFFERENT) |
| Name:
___________________________________ |
Name:
_____________________________________ |
| Address:
_________________________________ |
Address: ___________________________________ |
| City:
_____________________________________ |
City: ______________________________________ |
| State:
______ ZIP: _________-________ |
State: ______ ZIP: _________-________ |
| Contact
Name:
_____________________________ |
Daytime
Phone #:
_____________________________ |
| Email:
____________________________________ |
Fax
#:
______________________________________ |
| Name
&
Rate:_________________________________________________________________________
Circle One: United States Navy Retired USN Submarine Veteran Boat Name:____________________________________________________________________________ |
VIRGINIA RESIDENTS ADD 5% SALES TAX
| Credit Card #:_______________________________________________ Exp. Date: ___________________ |
| Credit Card 3/4 Digit Security Code: ____________________ |
| Card Holder's Name As Imprinted On Card (PRINT): _____________________________________________ |
| Card Holder's Signature: __________________________________________________________________ |
| (Unsigned
credit card orders or orders without the credit card security
code WILL
NOT Be Processed)
|