Submarine Print Order Form

SUBMARINE SHIP'S STORE SUBMARINE ART PRINT ORDER FORM

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 money order, please mail this form along with your payment to the address at the bottom of the form. Orders shipped via USPS Priority Mail. PLEASE remember to give us your email address and/or a 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 #: ________________________________________

Basic Print	Submarine Data Prints
Boat Name:	Boat Name:
11" X 17" Prints ____ @ $40.00 each	11" X 17" Prints ____ @ $45.00
13" X 19" Prints ____ @ $45.00 each	13" X 19" Prints ____ @ $50.00

**INFORMATION BELOW FOR PERSONALIZATION ON YOUR PRINT IF DESIRED**
Name & Rate/Rank:___________________________________________________________ Circle One: Silver Dolphins Gold Dolphins Years Onboard:_______________________________________________________________

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)

^{Mail To:}

^{The Submarine Ship's Store 301 Whitworth Drive, Culpeper, VA 22701-2009}

^{Voice (540)727-7612 * Fax (540)727-7613}