Two Chicks®
Mail Order License Plate Frame
Order Form
Print this form from the "print" option in your web browser. Complete the
form, and mail it along with your credit card info, check or money order.
Allow two weeks delivery.
Date:_______________
Shipping Information:
Name: __________________________________
Address: ______________________________________________________
City:________________________ State/Prov: _____________ Postal/Zip Code:____________
E-Mail Address:____________________________________ Telephone:__________________
Order Information:
Frame Type, circle one: (Automobile/Motorcycle)
Frame Color, circle one: (Chrome/Black)
Frame Style, circle one: (Small Panel Message On The Top/Small Panel Message On The Bottom)
Background Color:_______________________ Lettering Color:_______________________
Small Panel Message:________________________________________
Large Panel Message:_______________________________________________________
Payment Information:
Circle one: Check/Money Order/Visa/MasterCard
Name on card:____________________________________
Card #:__________________________________________ Expiration Date:____/____
Card Holder Signature:______________________________
For Credit Card Validation:
Enter exactly as it appears on credit card statement if different
from shipping information:
Address: ______________________________________________________
City:________________________ State/Prov: _____________ Postal/Zip Code:____________
Number of Frames:___ Price per Frame Including S/H:$_____ Total Order Amount: $________
Make checks payable and mail to:
Two Chicks
263 Wall Street
Corning, NY 14830
© Copyright, Two Chicks®, 1997-2005. All rights reserved.
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