Merchandise Order Form



INSTRUCTIONS:
The USRA does provide secure online transactions, but if you prefer to fax your order, or mail it with payment, you may print the following order form to place your order. To do so, please:

  • Either type your answers into the spaces provided before printing, or
  • Print a blank form and complete it by hand, making sure that all spaces are filled in.
NAME:
ADDRESS:
CITY:
STATE:
Zip/Postal Code:
COUNTRY:
PHONE (Day):

In case we have questions about your order.
PHONE (Evening):
FAX:
EMAIL:
Order Form ...You'll have to print it and fill it in ...
Item# Description Color Size How Many? Price Subtotal
__________ __________________________ ______ ______ ______ __________ __________
__________ __________________________ ______ ______ ______ __________ __________
__________ __________________________ ______ ______ ______ __________ __________
__________ __________________________ ______ ______ ______ __________ __________
__________ __________________________ ______ ______ ______ __________ __________
__________ __________________________ ______ ______ ______ __________ __________
__________ __________________________ ______ ______ ______ __________ __________
SUBTOTAL __________

Add $6.95 shipping & handling for first three pieces:

 __________

Add $1.00 per piece additional for orders of over three items:

 __________

Please allow 4-6 weeks for delivery ...

 TOTAL __________
Credit Card Information

CREDIT CARD ACCT.#:
MasterCard or VISA only

EXPIRATION DATE:

Cardholder Name:
(type or print):

Cardholder Signature:

    FYI ...
  • A printed merchandise ad appears in RACQUETBALL magazine.
  • Please allow 4-6 weeks for delivery.
  • Questions? Want to place a credit card order by phone? Call 719/635-5396, x120.
  • Want to FAX your order? Print an order form and fax it to 719/635-0685.

  • To place your order, print and complete the form, then mail with payment to:
    USRA, 1685 West Uintah, Colorado Springs, CO 80904-2906

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