PRICE TOTAL $ FIBA Shot Clock *pair

SHOT CLOCK ORDER FORM
REG.
FIBA Shot Clock *pair
Includes: 2 clocks, console, 2 wire cables, power cables, advertising panels,
advertising plates, & manuals.
Portable Rolling Stands *pair
Wire Protective Cover for Wall Mounting *pair
Protective Carry Bag
Holds pair of clocks
Complete Accessory Package
Includes: Portable rolling stands (pair), wire protective covers (pair)
& protective carry bag.
PRICE
PRICE
$1495.00
$995.00
$299.99
$199.99
$99.99
$79.99
$74.99
$49.99
$475.00
$278.00
TOTAL $
Special Bundle Price
Method of Payment
Credit Card
QUANTITY
Shipping & Handling $50.00 per clock (mandatory)
Cheque (Please make cheques payable to T.Litzen Sports)
SUBTOTAL
Card Type:____________________________________
Card Number: ___________________________________________ Expiry Date: ____/____
Card Holder: _____________________________________________________
TAX GST
6%
PST
%
Signature: _______________________________________________________
$______________
$______________
$______________
$______________
TOTAL $ ______________
BILL TO:
SHIP TO:
Organization: ___________________________________________
Contact: _______________________________________________
Street: ________________________________________________
Province: __________________ Postal Code: _________________
Phone: (______)_____________Fax: (______)_________________
Email:__________________________________________________
Organization: ___________________________________________
Contact: _______________________________________________
Street: ________________________________________________
Province: __________________ Postal Code: _________________
Phone: (______)_____________Fax: (______)_________________
Email:__________________________________________________
Same as billing
T. Litzen Sports | 433 Ofield Road South | Dundas, Ontario | L9H 5E2 | Phone: 800-603-5164 Ext. 297 | Fax: 905-628-3355 | sales@tlitzen.com | www.tlitzen.com