MERCHANDISE ORDER FORM
Qty Description Price Total
____ Cyndie Allemann Signed Poster SOLD OUT $ N/A
____ Cyndie Allemann Tshirt (size sm) $22.00 ea. $ _________
____ Cyndie Allemann Tshirt (size Med) $22.00 ea. $ _________
____ Cyndie Allemann Tshirt (size Lg) $22.00 ea. $ _________
____ Cyndie Allemann Tshirt (size X-Lg) $22.00 ea. $ _________
____ Cyndie Allemann Tshirt (size XX-Lg) $24.00 ea. $ _________
____ Cyndie Allemann Hero Card $ _ N/C___
Shipping & Handling for Posters (US only. International extra) $ 3.00
Shipping & Handling for Tshirts (US only. International extra) $______4.00
(up to two shirts. $1.00 extra per additional shirt)
TOTAL $ _____ ____
Payment Type (check one):
( ) Check or Money Order ( ) Credit Card
Credit Card Type:
( ) VISA ( ) MASTERCARD ( ) AMERICAN EXPRESS
Name as it appears on the card ___________________________________
Card Number ________________________________________
Expiration Date _________ Security number (3 digit number on back of card) _______
Billing Address for card: _____________________________________________
_____________________________________________
Ship to: ___________________________________________ AGE: _________
___________________________________________
___________________________________________
Fax Credit card Order to: (239) 283-3306
Send Check or Money Order to: American Spirit Racing, 1616-102 W. Cape Coral Pkwy, PMB-271
Cape Coral, Florida, USA 33991