TS Racing Order Form

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Tech info and questions:
1-352-793-9600

Orders only toll-free:
1-800-962-4108

24 hour fax:
1-352-793-4027

My name and mailing address:	Ship to:	Customer Id #___________
Name_____________________________	Name_____________________________
Company __________________________	Company __________________________
Address ___________________________	Address ___________________________
Address ___________________________	Address ___________________________
City _____________ St ____ Zip_______	City _____________ St ____ Zip_______

Home ph______________ Daytime ph_________________ Fax _________________

Indicate if your ship to address is a commercial or residental address

	Part #	How Many	Description	Pg #	Price Each	Total
1
2
3
4
5
6

FedEx UPS
Shipping Methods:
O - Regular-ground service
O - 3 day air service
O - 2 day air service
O - 1 day air service
O - 1 day air service (Sat.)

Please use an extra sheet when ordering more items
Thank you for your order
If an item is not available due to a manufacturer's back order:

O Advise what is B/O before shipping
O Hold order to ship complete
O Ship items in stock today at current prices

Fl Res. add sales tax __________

Fl county__________________

Freight ______________________

Total ________________________

Payment Method: Credit Card, COD: Money Order, Certified/Cashiers Check or Prepaid.
UPS no longer accepts COD cash.
Orders other than Credit Card, please call in advance for exact total which will include shipping.

Please circle method of payment: Visa, MasterCard, Discover or UPS COD
Exp. Date

Account number

Print Name______________________ Authorized Signature_____________________
All prices, term and availability subject to change without notice. Copyright © 1999 - 2003 B/Z Technologies. All rights reserved. Terms of use.