BENCH RACING DIECAST 

ONLINE ORDER FORM:

DISCOVER.GIF (1839 bytes)

Fill out the form with your choices and click Send
You will receive an email confirmation of total.
Your card will not be charged until items are shipped!

(if you need more than 12 lines.. simply submit a new form.. 
we will combine them for you!







Your name:

Street Address:

City:

State:

Zip:

Country:

Phone:

Auction Number: If Any

Item1 number & Name:

Quantity1:

Price1:

Item2 number & Name:

Quantity2:

Price2:

Item3 number & Name:

Quantity3:

Price3:

Item4 number & Name:

Quantity4:

Price4:

Item5 number & Name:

Quantity5:

Price5:

Item6 number & Name:

Quantity6:

Price6;

Item7 number & Name:

Quantity7:

Price7:

Item8 number & Name;

Quantity8:

Price8:

Item9 number & Name:

Quantity9;

Price9:

Item10 number & Name:

Quantity10:

Price10:


Sub Total:


Grand Total:

FOR THE FORM TO SECURELY
ACCEPT YOUR CARD NUMBER,
PLEASE DO NOT REMOVE THE LETTER CODE IN THE BOX!
THANK YOU.

YOUR Number:
 


Expiration number:


E-mail address:


Comments:




 

  

If you prefer not to online submit..

Please Follow These Instructions!

  1. Print off this page & Fill it out... Then 
    Fax or Mail it...  or Copy it and Paste into an Email, then fill it out & send it!

  2. When done.. Then Either:
    Fax
    (315-597-6892)  or 
    Snail mail us your order, (BENCH RACING DIECAST - KEITH STELL
    , PO BOX 252, PALMYRA, NY 14522; or
    Email the completed form to Keith@sexybloomers.com 

  3. We will accept your Phone orders: (315) 597-5330 Any Time 
    Between 8 am - 10 pm EST
    . Monday - Sunday    (no collect calls please!)
    Questions? Keith@sexybloomers.com
    Store: (315) 331-7843

  4. We ship only via USPS  Priority Mail with Delivery Confirmation.
    If you wish to pick up your order, Please call ahead.

  5. We do accept Money Orders, payable to Keith Stell.  
    Sorry, we do not accept personal checks.

  6. You can request your Money Orders Online from Western Union :
    http://www.moneyzap.com

BENCH RACING DIECAST
P.O. Box 252 - 4496  South Creek Road
Palmyra, New York 14522
(315) 331-7843 Store
(315) 597-5330
Fax: (315) 597-6892 
Email: Keith@sexybloomers.com


YOUR MAILING ADDRESS:

Name: __________________________________________

Address: ________________________________________

City: ______________________ State: _____ Zip: _______

Telephone: _________________ Fax: _________________

Email:__________________________________________
 

USPS SHIPPING ADDRESS (Required)

Name: __________________________________________

Address: ________________________________________

City: _____________________ State: _______ Zip: ______


GIFT CERTIFICATES! ______ check here!
Also use this form below


GIFTEE:

NAME: _________________________________________________

ADDRESS: ______________________________________________

UPS STREET:_____________________________________________

CITY: _____________________ STATE:__________ ZIP: ________

 

GIVER: __________________________________________________

ADDRESS: _______________________________________________

CITY: _____________________ STATE: __________ ZIP: _________

PHONE: ___________________ Email: ________________________



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Date Received:____________

DELIVERY:

We ship USPS  priority mail throughout the usa! 

Shipping is FREE in USA!

Thank You for Your Order!

Return Policy

(1) 20% Restocking charge on orders that are refused unless  defective.

(2) Shipping and Handling are non refundable

(3) Item will be replaced or refunded only if  defective

   Catalog No.    Item                          Quantity     Price
1. ___________    _____________________________  _______   _________
2. ___________    _____________________________  _______   _________
3. ___________    _____________________________  _______   _________
4. ___________    _____________________________  _______   _________
5. ___________    _____________________________  _______   _________
6. ___________    _____________________________  _______   _________
7. ___________    _____________________________  _______   _________
8. ___________    _____________________________  _______   _________
9. ___________    _____________________________  _______   _________
10.___________    _____________________________  _______   _________
Add lines as you need them
 

Subtotal:_____________________

NYS 7% Sales Tax (for NYS residents Only) :____________

Shipping:_____________________ TOTAL:_____________________________

METHOD OF PAYMENT: _____Money Orders payable to Keith Stell
CHARGE TO:_____VISA ____MASTERCARD ____DISCOVER ____

Card# ____________________________________ Exp. Date: _____/_____

Signature _________________________________ Daytime Phone:____________

paypal-xcom.gif (1626 bytes) We ACCEPT Paypal
  Keith@SEXYBLOOMERS.COM
 (Stell)
 
IF USING PAYPAL: LEAVE PAYPAL ID HERE:__________________________

 

Email to: admin | info | webmaster

Bench Racing Diecast
P.O. Box 252 | 4496 South Creek Road
Palmyra, New York 14522
Telephone:  (315) 597-5330 / (315) 331-7843
Fax: (315) 597-6892