Printable Order Form for Faxing or Mailing (This is not for placing an order over the internet.)
Burleson Sporting Company
PO Box 6305
Montgomery AL 36106 		Phone: 1-800-871-5346
Phone: (334) 265-6640
Fax: (334) 265-7051 		www.burfish.com

Ship To: Bill To (If Different):
First Name:
Last Name:
Email Address:
Phone Number:
Fax Number:
Company:
Address:
City:
State/Province:
Other State/Province:
Zip/Postal Code:
Country:
First Name:
Last Name:
Email Address:
Phone Number:
Fax Number:
Company:
Address:
City:
State/Province:
Other State/Province:
Zip/Postal Code:
Country:

Payment With: Payment Information:
Visa
Mastercard
Check
Money Order
Name on Card:
Card Number:
Expiration Date: /
Item # Product Description Quantity Price/Ea. Total

  Ship Via:
  Total:

Print this Page. Then Mail or Fax To:
(This is not an internet order form) 		Burleson Sporting Company
PO Box 6305
Montgomery AL 36106
Phone: 1-800-871-5346
Phone: (334) 265-6640
Fax: (334) 265-7051