SOLD TO:Name___________________________   SHIP TO:Name____________________________
Street/                                     Street/
PO Box__________________________________    PO Box__________________________________

City________________ State___ Zip_______    City________________ State___ Zip_______

Phone (Day)_____________________________    Email or 2nd phone no __________________ 




QTY.
ITEM NO.
SIZE
COLOR*
STYLE
DESCRIPTION
PRICE EACH
TOTAL


 
 
 
 
 
 
 
 


 
 
 
 
 
 
 
 


 
 
 
 
 
 
 
 


 
 
 
 
 
 
 
 


 
 
 
 
 
 
 
 


 
 
 
 
 
 
 
 


 
 
 
 
 
 
 
 


METHOD OF PAYMENT
                                                              SUB-TOTAL __________
___MasterCard   ___VISA
                                                    SHIPPING AND HANDLING __________
___Discover
                                                                   TOTAL __________
___Check**      ___Money Order** 
**Orders paid by check or money order must be mailed, not faxed.   
CREDIT CARD NUMBER
 |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
 ________________________________________________________________
EXPIRATION DATE     SIGNATURE
 |   |   |   |   |
 ________________      _____________________________________________________________
SHIPPING AND HANDLING CHARGES
$19.99 and under. $7.50    $50.00-$74.99 . . $12.50   $100.00-$199.99 . . $18.00
$20.00-$49.99 . . $9.50    $75.00-$99.99 . . $15.00   $200.00-$299.99 . . $21.00
Orders $300.00 and up      7% of total order

The following additional charges apply to all orders:
Orders shipped to any non-USA destination will be shipped US Mail Global Priority or 
Global Express and actual shipping costs will be charged. 
Please allow 7-10 working days for most deliveries.
There is no shipping and handling charge for gift certificate purchases.

We accept MasterCard, Visa, Discover, personal check or money order for orders from within the United States and Canada. International orders must be paid by bank check or money order in US funds. Sorry, we do not ship COD. Orders paid for by check are processed when the check clears, usually in about seven business days. $20.00 fee for returned checks. For complete order and return information, see the inside back cover of the Freedom Rider catalog, or the "How to Order" section of our website (http://www.freedomrider.com).

*If the color requested isn't available, we reserve the right to substitute another color unless you specify "no color substitutions."