Submarine Coffee Mug Order Form

SUBMARINE PATCH (SUBMUG) 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 M.O., please mail this form along with your payment to: THE SUBMARINE SHIP'S STORE, 301 Whitworth Drive, Culpeper, VA 22701.
Orders shipped to other than USPS Zip Coded addresses will be billed actual USPS shipping costs.

Using the image above, indicate below on which side (1 or 2) of your SubMug your submarine patch is to be imprinted and provide your personalized text on the reverse side. Please PRINT or TYPE all information. For best appearance please use a maximum of 3 lines, 13 characters/spaces per line

PATCH # OR PERSONALIZATION	PATCH # OR PERSONALIZATION
Line 1: ________________________	Line 1: ________________________
Line 2: ________________________	Line 2: ________________________
Line 3: ________________________	Line 3: ________________________

Please provide us a daytime phone number and your email address should there be a question about your order. Our Privacy Policy is very simple. We DO NOT provide ANY of your information to ANYONE for ANY reason!!

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 #: ______________________________________

SUBMUGS $19.95 EACH - 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}