Print Out Mail Order Form
Mail or FAX order to: ----------------------------------------------------------------------------------------------------------------
| Walls of Fame Autographs | [_] Visa | [_] American Express |
| PO Box 86132 | [_] Master Card | [_] Money Order |
| Madeira Beach, FL 33738 | [_] Discover |
| Tel: (727) 392-4450 | Card # | ____________________________ |
| Fax: (727) 392-5180 | Exp. Date | ____________________________ |
| Signature | ____________________________ |
Prices subject to change without notice. Write or call to insure correct price and availability.
| Name | Description | Price |
| ________________________________________ | __________________ | ______________ |
| ________________________________________ | __________________ | ______________ |
| ________________________________________ | __________________ | ______________ |
| ________________________________________ | __________________ | ______________ |
| ________________________________________ | __________________ | ______________ |
| ________________________________________ | __________________ | ______________ |
| ________________________________________ | __________________ | ______________ |
| ________________________________________ | __________________ | ______________ |
| ________________________________________ | __________________ | ______________ |
| Shipping Address: | Subtotal | ______________ |
| Name __________________________________ | Tax* | ______________ |
| Address ________________________________ | Shipping** | ______________ |
| ________________________________________ | Total | ______________ |
| ________________________________________ | ||
| City ____________________ State _______ | Zip ________ |
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* Florida Residents please add 7% sales tax. |