CLEMENTS CUSTOM GUNS ORDER BLANK
DATE ____________
NAME ___________________________________
ADDRESS ___________________________________________
CITY __________________STATE ________ZIP __________
PHONE NO.-HOME _______________WORK _______________
EMAIL _________________________________
SERIAL NO. OF GUN SENT ______________MFG. AND MODEL______________
BARREL LENGTH WANTED ___________________FINISH __________
INSTRUCTIONS AND OPTIONS
_____________________________________________________________
_____________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
AMOUNT OF PAYMENT ENCLOSED ___________________
Complete the blanks below if paying by MC or Visa, debit or credit.
CARD NO. _________________________________________
EXPIRATION DATE __________________________________
NAME ON CARD ____________________________________
ZIP CODE OF BILLING ADDRESS ______________________
UPS & USPS shipping address:Clements Custom
2766 Mt. Zion Road
Woodlawn,Va. 24381
|
|
|