Fax Order Form

ULTIMATEFLAGS .com
** Print this form **

413-556-7425

Fax Order Form

413-556-7425

Print this form and fax or mail it in to 413-556-7425.
Ultimateflags.com
1595 Peachtree Pkwy Ste #204, PMB #241
Cumming, GA 30041

Please fill it out completely. Thanks!

Don't Forget - order 2 flags get your 3rd flag FREE!

FLAG	SIZE	PRICE
1. _________________	_________________	________
2. _________________	_________________	________
(free)_________________	_________________	________
_________________	_________________	________
_________________	_________________	________
Price Sub-Total:		________
Shipping/Handling ($5 per flag):		________
Add $5.00 for priority Shipping. Sorry no overnight service is available)
TOTAL (US funds):		________

SHIPPING INFORMATION:	PAYMENT INFORMATION:
YOUR NAME: ________________	[ ]VISA [ ]MasterCard [ ]American Express
Address: ____________________	Card Number: ______________________
_______________________________	Expiration Date: _____________________
City : _______________________	Exact Name on Card: ________________
State/Prov.: __________________	Billing Address for card (required for security)
ZIP/Postal Code: _____________	_________________________________
Phone: _____________________	_________________________________
E-mail: _____________________	_________________________________

SPECIAL INSTRUCTIONS OR COMMENTS:

Thanks you for your order. If you provided an e-mail address, you will receive an e-mail confirmation from our Shipping Department.