Revel Sports - Mail Fax Order Form

www.RevelSports.com

Revel Sports
1903 Weston Ave
Schofield, WI
(866) 502-4125

Bill To:		Ship To:
Name:	.	Name:	.
Address:	.	Address:	.
	.		.
City, State ZIP:	.	City, State ZIP:	.
e-mail:	.	e-mail:	.
Phone:	( )	Phone:	( )

Order:
Item #	Item Description (include color, options, etc.)	Size	Qty.	Price	Extended
.	.	.	.	$	$
.	.	.	.	.	.
.	.	.	.	.	.
.	.	.	.	.	.
Specify shipping method _______________________				Shipping
				WI 5.5% Sales Tax
				Total	$

Payment Info: Note: These are the only forms of payment we accept (Orders paid with a personal check will be held until the check clears the banking process).

Money Order included

----------------------------------------------------- Card Number ---------------------------------

Exp

Credit Card V-Code:

For your security, and for credit card fraud prevention, we require the V-Code (CVN) on your credit card. This number is separate from your regular card number and only appears on your card. Visa, MasterCard, and Discover card holders should flip your card over. You will see your 16 digit card number followed by another 3 digits. This is your V-Code. American Express card holders will find their V-Code as 4 digits just above the card number.

_______________________________________________
Signature of Cardholder…must match "Bill To" name above.

I authorize Revel Sports to charge the credit card number indicated above for the total above plus sales tax (if applicable). I certify that the credit card number and signature above agree to the "Bill To" name above and that, as such, I am an authorized signer on this card.