I.D. IT! Plate Retail Order Form

Customer Information

Telephone______________Fax______________ Email __________________

Please tell us your referring partners ID #   ________

Shipping Address same as above, or:

QUANTITY  _______       TYPE:   {   } Chrome         {   } Gold

TEXT "EXACTLY" AS YOU WOULD LIKE YOUR PLATES TO READ 
(remember, 22 character limit - use other side for additional plates)

Plate 1:  ____________________________________________

Plate 2:  ____________________________________________

Plate 3:  ____________________________________________

Plate 4:  ____________________________________________

 TOTAL PRICE OF YOUR ENTIRE ORDER: $ (U.S.) _____________

Payment Method:  Visa  MC   AMEX  Business Check  Money Order
(make money orders or business checks payable to "Rick Beneteau" and send this form to:

I.D. IT! Plates,
Brier Woods Village,
168F Dunsdon St.,
Brantford, Ontario,
CANADA N3R 6T3