Torpedo Zone Mail Order Form Please print out and fill in all the appropriate fields in the form below, and mail with a check or money order, payable in US$, to : Torpedo Zone 7546 Battle Creek Road SE Salem, OR 97317 If a credit card purchase, be sure to fill in the required information at the bottom of the form. Please type or print the information below as we cannot process your order if we cannot read the form. After receiving your order, we will email you a confirmation. When your check clears the bank / money order is cashed / credit card is accepted, we will ship your order. Item #______________: Design Style______________________ Price: US$__________ Quantity: ___ Total: US$_________ Item #______________: Design Style______________________ Price: US$__________ Quantity: ___ Total: US$_________ Item #______________: Design Style______________________ Price: US$__________ Quantity: ___ Total: US$_________ Item #______________: Design Style______________________ Price: US$__________ Quantity: ___ Total: US$_________ Grand Total: US$ ______________ Full Name: ___________________________________ Company (if applicable): ___________________________________ Address: ___________________________________ City: ___________________________________ State: _________________ Zip Code: _________________ Shipping Address: (if different from above) ___________________________________ Credit Card # (if applicable): _________________ Expiration Date: _________________ 3- or 4-digit code: (on back of card) _________________ Billing Address (if credit card): ___________________________________ Email Address: ___________________________________ Phone Number:   area code (      ) _____________________