Order Form     
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Customizing Orders: Please print out this form, fill it out, and include it with jerseys when shipping. Shipping is not included in quotes and is additional charge. Please try and be as specific as possible with all orders, e.g. size, H/R, color, name, number, "C", etc. The name and number on the Order Form is what will be applied to your jersey. If you would like Jerry Rice customizing, please put RICE #80, not JERRY RICE #80.
A T T E N T I O N !   All orders subject to $50 cancellation fee
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will receive a confirmation e-mail (online submissions only). If you experience a problem when submitting your order, please use one of the following options:
  • Phone your order in to our sales desk: (815) 877-8585  or
  • Print and Fax this form to our 24 hour Fax line: (815) 877-8544  or
  • Print and mail this form to

     Exclusive Pro Sports
    5035 28th Ave.
    Rockford, IL
    61109
    Attn:Internet Orders
     
  • Questions?   E-mail Us!

Billing Address:
Full Name
Email
 Phone
Street Address
City
 State
 		 Zip
Shipping Address:  Only if different
Full Name
Email
 Phone
Street Address
City
 State
 		 Zip


Payment Information:
Visa Mastercard Discover American Express  
Account No.
 Expiration Date
Name on Card
Card Security Code (3 Digit Number on Back Right Corner)
   
Signature: If mailing or faxing
________________________________________________


Order Information   Shipping within the United States is $13.95, up to 1 lb. (1 jersey), prices vary by weight after that. PLEASE DECLARE IF YOU WANT JERSEYS/KITS COMPLETED IN A LAYERED OR REVERSE KISS CUT STYLE.
Description (customizing info) Size Qty Price
 
 
 


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