HTML HAT ORDER FORM

Bill to

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Name

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Company

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Address

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City/State/Zip Code

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Area Code/ Day Time Phone/ Extension

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Area code/ Fax Number
Shipping and Handling
Shipping: Add $4.25 Per Order

Ship to

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Name

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Company

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Address

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City/State/Zip Code

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Area Code/ Day Time Phone/ Extension

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Area code/ Fax Number

Payment Information
Check or Money Order (Payable to CMD)

Master Card Visa American American Express
Card Number ________________________ Expiration date ____________

Print name as appears on card_____________________________________

Card Holders Signature__________________________________________

Item Description Quantity Price Total
1 Brushed Twill Cap-Driftwood/Black ________ 12.50 ________
2 Brushed Twill Cap-Dark Pine ________ 12.50 ________
      Subtotal ________
      Shipping 4.25
      Total Order
US funds		 ________

Send Orders to:
Promotion Marketing
1732 NW Quimby St Portland,
OR 97209
Phone (503) 535-1365
Fax (503) 274-8999

To order by Phone Call: 1-503-535-1365 CMD
Fax Orders to: (503) 274-8999

E-Mail Orders to: pmay@cmdpdx.com

Please allow 7 working days for delivery. All orders will be shipped UPS ground service.