Mail-In Offline Order Form
SHIPPING
INFO
| BILLING
INFO (fill in only if different) |
| Name | ____________________ | Name | ____________________ |
| Address | ____________________ | Address | ____________________ |
| Address | ____________________ | Address | ____________________ |
| City | ____________________ | City | ____________________ |
| State | ____________________ | State | ____________________ |
| Zip | ____________________ | Zip | ____________________ |
| Phone | ____________________ | Phone | ____________________ |
| Email | ____________________ | Email | ____________________ |
| CREDIT
CARD INFO (if not paying by check or money order) |
|
We accept credit cards, checks and money orders from the US, including APO/FPO's. We accept credit cards and international money orders from Puerto Rico. We do not accept orders from any other countries. |
| Card # | ____________________ | Exp. | ____________________ |
| Name on Card | ____________________ | Type | Visa Mastercard
Amex (circle one) |
| CSC Code | ____________________ | What
is a CSC Code? Visa/MC | Amex
|
| Standard Ground Shipping |
| Order Total |
Shipping Cost |
| $0.01-$19.99 |
$10.00 |
| $20.00-$49.99 |
$12.00 |
| $50.00 and up |
$14.00 |
| More shipping options for AK, HI, Puerto Rico, Economy & Express shipping: See Chart |
| PURCHASE
INFO |
| Product Code | Description Size/Color
(if applicable) | Qty | Price Ea. | Total |
| ______ | _______________________________ | ____ | $_______ | $______ |
| ______ | _______________________________ | ____ | $_______ | $______ |
| ______ | _______________________________ | ____ | $_______ | $______ |
| ______ | _______________________________ | ____ | $_______ | $______ |
| ______ | _______________________________ | ____ | $_______ | $______ |
| ______ | _______________________________ | ____ | $_______ | $______ |
| ______ | _______________________________ | ____ | $_______ | $______ |
| ______ | _______________________________ | ____ | $_______ | $______ |
| ______ | _______________________________ | ____ | $_______ | $______ |
| | | Subtotal | $______ |
| Shipping Method | _______________________________ | Shipping | $______ |
| | | GRAND TOTAL | $______ |
If there is not enough room on this form attach your own paper or
use two forms.
Mail this completed form to:
Army Navy Shop, 37 E. Scott St., Riverside, NJ 08075
or you can email it 24/7 to:
customerservice@armynavyshop.com
