Marine Corps Activewear Mail Order Form


Please Print this form and send it through postal mail!
2010 S. Roosevelt St #3, Joplin, MO 64804



Customer Name:
 
Phone Number:
 
E-Mail:
 
Pay Method:
(Check, Credit, MO)
 
Credit Card Number:
 
Exp. Date:
 
V-Code*:
 
Name On Card:
 
Address:
 
City:
 
State:
 
Zip:
 

Ship To Name: Ship To Phone:
Shipping Address:
 
Shipping City:
 
Shipping State:
 
Shipping Zip:
 

QTY Code Size Color
(1st Choice)
Color
(2nd Choice)
Description Price Ext. Price
               
               
               
               
               
               
               
               
               
               
Sub Total:  
Missouri residents please add 7.85% sales tax to total (multiply by .0785) Tax:  
S&H:  
Total:  
Delivery Method Regular Rush Express

SIGNATURE

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* The V-Code is a three digit security verification number usually found on the back of MasterCard and Visa cards, and is the last three digits.