Printable Order Form
To submit an order, please print this form and mail to:
Dicks Online Orders
2122 Country Club Dr.
Suite 220,
Carrollton, TX 75006
Please make out checks to Fine Incentives
Or Fax to:
972-478-2392
Please allow 4 to 6 weeks for shipping.
Items Ordered:
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Item Number |
Item Title |
Size |
Color |
Quantity |
Price |
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e.g. 00125 |
e.g. Short-sleeve T-shirt |
e.g. Med |
e.g. Blue |
e.g. 1 |
e.g. 14.95 |
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Plus 8.25% sales tax (TX residents only) |
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Please call 972-418-9462 for Shipping & Handling Price |
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Total |
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For more items, please print and include a second form.
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Customer Information
*First Name ________________________
*Last Name ________________________
Company ________________________
*Email ________________________
Phone _________________________
Credit Card Information
*Card Type ________________________
*Cardholder’s Name As Shown On Card ___________________________________
*Card Number ______________________
*Expiration Date (mmyy) ____ / ____
*3 Digit Security Code _______________
*Required fields. |
Billing Address
*Address Line 1 ______________________
*City _______________________________
*State/Province _______________________
*Country _____________________________
*Zip/Postal Code ______________________
Shipping Address (if different from billing address)
Ship To Name __________________________
Address Line 1 __________________________
City __________________________________
State/Province __________________________
Country _______________________________
Zip/Postal Code _________________________
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Thank you for ordering from Dicks Last Resort online. If you have any questions, please do not hesitate to contact us by phone at: 972-418-9462 / 800-752-3463, or by email at: linda@fineincentives.com
