Clubware Order Form

Merrymeeting Wheelers Bicycle Club

Clubware Order Form

To order your MWBC Clubware items, please fill out the information required below, print this form and send with your payment to:
                                    Merrymeeting Wheelers Bicycle Club
                                    PO Box 233
                                    Brunswick, ME 04011-0233

If you require shipping, please request shipping and handling charges prior to mailing payment. Send inquiry with ordering data to: clubware_order@merrymeetingwheelers.com

WARNING!!! Use the "Tab" key to move between fields and to enter data. Use of the "Enter" key is bound to have a negative impact on your attitude.

[FrontPage Save Results Component]

Please provide the following contact information:

First Name

Last Name

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

Home Phone

E-mail

Are you a member of MWBC?

Yes No

Please provide the following product information:

PRODUCT QTY SIZE/DESCRIPTION

Shipping and Handling:

Total:

Shipping information is required only if different than contact information above.

SHIPPING

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

PRODUCT	QTY	SIZE/DESCRIPTION










		Shipping and Handling:
		Total:

	SHIPPING
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

Author information goes here.Copyright © 2003 [Merrymeeting Wheelers Bicycle Club]. All rights reserved. Revised: May 06, 2003

Author information goes here.
Copyright © 2003 [Merrymeeting Wheelers Bicycle Club]. All rights reserved.
Revised: May 06, 2003