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Customizing Orders: Please print out this form and include it with jerseys when shipping. Please try and be as specific as possible with all orders, e.g. size, H/R, color, name, number, "C", etc. The name and number on the Order Form is what will be applied to your jersey. If you would like Jerry Rice customizing, please put RICE #80, not JERRY RICE #80.
A T T E N T I O N !   All orders subject to $50 cancellation fee
 This form is not compatible with all browser types. When your order is placed you
will receive a confirmation e-mail. If you experience a problem when submitting your order,
please use one of the following options:
  • Phone your order in to our sales desk: (815) 877-8585  or
  • Print and Fax this form to our 24 hour Fax line: (815) 877-8544  or
  • Print and mail this form to

     Exclusive Pro Sports
    5035 28th Ave.
    Rockford, IL
    61109
    Attn:Internet Orders
     
  • Questions?   E-mail Us!

Billing Address:
Full Name
Email
 Phone
Street Address
City
 State
 		 Zip
Shipping Address:  Only if different
Full Name
Email
 Phone
Street Address
City
 State
 		 Zip


Payment Information:
Visa Mastercard Discover American Express  
Account No.
 Expiration Date
Name on Card
Card Security Code (3 Digit Number on Back Right Corner)
   
Signature: If mailing or faxing
________________________________________________


Order Information   Shipping within the United States is $10.50, prices vary by weight after that.
Description (customizing info) Size Qty Price
 
 
 


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