For mail-in orders please print out this page, and mail
or fax the completed form to:

 
PEARCE  GRIP, INC.
P.O. Box 40367
Fort Worth, TX 76140
817-568-9704 FAX
 


        
PEARCE  GRIP, INC.
P.O. BOX 40367
Fort Worth, Texas 76140


Info (817) 568-9704 Order (800) 390-9420 Fax (817) 568-9707
Online www.PEARCEGRIP.com     

ORDERS: 1-800-390-9420

  

CUSTOMER ORDER FORM
BILL TO
NAME_________________________________
ADDRESS_________________________________
CITY_______________ ST____ ZIP________
SHIP TO DATE_______________
NAME___________________________________
ADDRESS___________________________________
CITY_______________ ST____ ZIP__________
PAYMENT BY:   CHECK   MONEY ORDER   VISA   M/CARD   DISCOVER
CARD #_________________________________ EXPIRES____________ VER.CODE__________
SIGNATURE_______________________ PHONE NO.________________ (Last 3 digits in "signature" stripe
on back side of credit card.)
E-MAIL ADDRESS_____________________________________________
Quantity
Ordered		 Product Stock No. Product Description Unit Price Extended
Total
                             
                             
                             
                             
                             
                             
                             
                             
                             
                             
Domestic Shipping Charges
$0.00  to  $29.99 $3.00
$30.00  to  $49.99 $4.00
$50.00  to  $69.99 $5.00
$70.00  to  $89.99 $6.00
$90.00  to  $109.99 $7.00
$110.00 & Over $10.00
2nd Day Air ......... Add $10.00
Next Day Air ......... Add $20.00

No Retail C.O.D. Orders!
Canadian Shipping Charges
$20 for the first item plus $3 for each additional item. Shipping by International Priority Mail.

Other Countries Approved For Export
$25 for the first item plus $5 for each additional item. Shipping by International Priority Mail.
Inquire in advance by fax or e-mail to see if Pearce Grip exports to your country.

All merchandise may be returned for exchange or credit if received by Pearce Grip no later than ten (30) days from date of original shipment.  All returns must include a Return Authorization # (RA), available by calling 817-568-9704.  All returns must be in original packaging and in unaltered condition (including packaging.) A copy of the original invoice must accompany all returns and please indicate on the invoice copy your reason for return or exchange.
SUBTOTAL    
SHIPPING    
SALES TAX
TEXAS RESIDENTS
ADD 8.25% 		   
TOTAL