Please print and fax this completed order form to (972) 418-1843. Or, you may mail the completed order form to:
GBN General Store
4098 Lindbergh Dr.
Addison, TX 75001
Please allow 4 to 6 weeks for shipping.
Items Ordered:
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Price |
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Plus 8.25% sales tax (TX residents only) |
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Plus $6.95 Per Item for Shipping & Handling |
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Plus an additional $10 to have items shipped by Federal Express |
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Total |
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For more items, please print and include a second form.
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Customer Information
*First Name _________________________
*Last Name _________________________
Company _________________________
*Email _________________________
Phone _________________________
Credit Card Information
*Card Type ___Visa____MC___AMEX__
*Cardholder’s Name As Shown On Card ___________________________________
*Card Number _______________________
*Expiration Date (mmyy) ______ / ______
*3 Digit Security Code _______________
*Required fields. |
Billing Address
*Address Line 1 _______________________________
*City _______________________________
*State/Province _______________________________
*Country _______________________________
*Zip/Postal Code _______________________________
Shipping Address (if different from billing)
Ship To Name _______________________________
Address Line 1 _______________________________
City _______________________________
State/Province _______________________________
Country _______________________________
Zip/Postal Code _______________________________ |
Thank you for ordering from the Gold Buckle Network General Store. If you have any questions, please do not hesitate to contact us by phone at: (972) 387-4320, or by email at GeneralStore@goldbucklenetwork.com.
