2022-23 Gifts

REORDER FORM (Please make additional copies for future use.) USE BLUE OR BLACK INK WHEN COMPLETING THIS FORM. 800-241-2094 Fax 800-880-9759 Local Fax 706-546-8482 Mail to:

Date_________________ P.O. Number__________________ Email Address_________________________________________ Fax #_________________________________________________ Customer #___________________________________________ Phone (Daytime) (_______)______________________________ Phone (Evening) (_______)______________________________ Name of person placing order___________________________ 2. ORDERED BY (Only if different from SHIP TO) Name of Business_________________________________ Division__________________________________________ Street Address____________________________________ City_________________________ State_____________ ZIP Code™___________ Country__________________

burton + BURTON ® 325 Cleveland Road Bogart, GA 30622 USA

1. SHIP TO Name of Business__________________________________ Street Address____________________________________ City_________________________ State______________ ZIP Code™___________ Country__________________

SECURITY CODE

3. METHOD OF PAYMENT VISA ® MASTERCARD ®

DISCOVER ® AMERICAN EXPRESS ® Expiration Date____________________ Signature as it appears on card____________________________________________ Name of Cardholder__________________________________ Bill To________________________________________________ City_________________________ State______________ ZIP Code™___________ Country______________________ CASHIER’S CHECK OR MONEY ORDER CHECK Please make check payable to burton + BURTON ®

Net 30 Attach credit application + authorization form

4. ORDER

Product Number

Description

Quantity

Unit Price

Total

1 2 3 4 5 6 7 8 9

10 11 12 13 14 15 May we substitute with similar product if out of any item?

Yes No Discounts, if any, will be calculated and applied to your order. Shipping and handling charges will be added to your order. For additional items, please use the other side of this page. Prices subject to change without notice. Orders subject to acceptance in Bogart, Georgia. Customer consents to the jurisdiction of any court in the State of Georgia and the laws of Georgia.

Total number of pages being transmitted including this sheet__________