PETERS BROS HATS MAIL ORDER FORM
QUESTIONS??? Please call or e-mail
INFO@PBHATS.COM800.TXS.HATS   (800-897-4287)

STORE HOURS 10AM---6PM CST MON.-SAT.

Please provide the following ordering information:
        BILLING
       Credit card     _______________________
Cardholder name  _______________________
Street address    ____________________________
Address (cont.)     _____________________________
                   City   _____________________________
  State/Province   _____________________________
Zip/Postal code    _____________________________
             Country    _____________________________
       Card number  ___________________C V V _Code___
   Expiration date   ______ Phone #_______________
       SHIPPINGIs this a residence
               Name     ____________________________
  Street address    ____________________________
Address (cont.)     _____________________________
                   City   _____________________________
  State/Province   _____________________________
Zip/Postal code    _____________________________
             Country    _____________________________
Please provide the following contact information:( if different )
               Name     ___________________________
    Street address   ___________________________
    Address (cont.)   ___________________________
                  City      ___________________________
   State/Province    ___________________________
Zip/Postal code      _________
            Country      _________
      Work Phone    ____________________
      Home Phone   ____________________
              E-mail     ____________________________