Freedom Rider Order Form
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Print out this order form. Mail your order to:

Freedom Rider
5225 Tudor Ct
Naples FL 34112 USA
You may also call us toll free at 1-888-253-8811 or fax your order toll free to 1-866-522-4708 (credit card orders only). From outside the United States call 1-603-540-0933. We accept VISA, MasterCard, Discover, American Express, personal check or money order for orders from within the United States and Canada. International orders must be paid by VISA, MasterCard, Discover, or American Express in US funds.

SOLD TO:
SHIP TO:
Name______________________________________
Name______________________________________
Street/
PO Box____________________________________
Street/
PO Box____________________________________

City___________________ State___ Zip______

City___________________ State___ Zip______

Phone (Day)_______________________________

Email or 2nd phone no ____________________

QTY. ITEM NO. SIZE COLOR* STYLE DESCRIPTION PRICE EACH TOTAL
               
               
               
               
               
               
               
METHOD OF PAYMENT

SUB-TOTAL

 __________
___MasterCard  ___VISA  ___Discover  ___American Express

FL residents add 6% sales tax

 __________
___Check**     ___Money Order**

Shipping and Handling

 __________

TOTAL

 __________
**Orders paid by check or money order must be mailed, not faxed.
CREDIT CARD NUMBER                                                    EXPIRATION DATE
|   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |     |   |   |   |   |
_________________________________________________________________     _________________
SECURITY CODE      SIGNATURE
|   |   |   |
_____________      ____________________________________________________________________
SHIPPING AND HANDLING CHARGES
$19.99 and under. $7.50    $50.00-$74.99 . . $12.50   $100.00-$199.99 . . $18.00
$20.00-$49.99 . . $9.50    $75.00-$99.99 . . $15.00   $200.00-$299.99 . . $21.00
Orders $300.00 and up      8% of total order

The following additional charges apply to all orders:
Orders shipped to any non-USA destination will be shipped US Mail Global Priority or Global Express and actual shipping costs will be charged.
Please allow 7-10 working days for most deliveries.
There is no shipping and handling charge for gift certificate purchases.
We accept VISA, MasterCard, Discover, American Express, personal check or money order for orders from within the United States and Canada. International orders must be paid by bank check or money order in US funds. Sorry, we do not ship COD. Orders paid for by check are processed when the check clears, usually in about seven business days. $20.00 fee for returned checks. For complete order and return information, see the inside back cover of the Freedom Rider catalog, or the "How to Order" section of our website (http://www.freedomrider.com).

*If the color requested isn't available, we reserve the right to substitute another color unless you specify "no color substitutions."