Eddie Carrier Jr. Racing Apparel Order Form

Please Complete & Print this Form and Return with Check/Money Order to the Following Address:

Eddie Carrier Jr.
Rt 2 Box 530B
Salt Rock, WV 25559

Please Allow 2-3 Weeks For Delivery

* Indicates Required Field

*NAME:

*ADDRESS:

*CITY: - *STATE: - *ZIP CODE:

DAYTIME PHONE: - *EVENING PHONE:

*E-MAIL ADDRESS:

2009 Hats and Beanies Check Box On Left, Enter Quanity and Total Cost
	PRICE	QUANITY	TOTAL
Black Flex-Fit Hat	$20.00
Camo Flex-Fit Hat	$20.00
Black Beanie	$18.00
SHIPPING & HANDLING
S&H (PER ITEM)	$5.00
GRAND TOTAL
Please Add All Amounts + S&H

Eddie Carrier Jr. Racing is NOT Responsible for lost orders or merchandise. Please send only
Checks or Money Orders made payable to Eddie Carrier Jr. with your printed order form.
Questions regarding sizes can be submitted to: eddiecarrierjr28@yahoo.com

Questions regarding order this order form can be submitted to
Jeremy Shields at shields_07@hotmail.com