Author: Kevin Brotzman Perso

Mail in Order form

Please include all required information so that we may serve you better

Name : _________________________ Phone : _____________ Date : _____
Address:________________________ Email : ________________________
City : ______________ State : ______ Best contact time : _______________
Zip Code : __________ Contact name : __________________
Mail to (if different)______________________________________________
Address :_______________________________________________________
City : _______________________ State : _________ Zip Code : ________

Please list design and color selections on list below. For a double check please circle the color on chart provided below. First (or) last name (or) nickname is included in price of design.
Additional names, or words may be added to the design at the charge of $2.00 per word, (as allowed by the design style). Please indicate where you want the design to be located front or back

Item #	Size	Name for Product	Color #1	Color #2	Color #3	Color #4	Units	Price	Total

Front of shirt

Back of shirt

Please make all payments payable to : Alteredair Custom Airbrushing
Mail payment and form to:
Alteredair Custom Airbrushing
146 Quail Ridge Dr.
Kyle, Tx. 78640
Shipping is a flat rate 4.95 up to 2 items
3 items or more 10.95 shipped by U.S.P.S.

For your connivance we can arrange for your order to be paid online through PayPal please email this order form filled out to kevin@alteredair.com for these arrangement to occur. We must have your email address for this

# of total items	Sales tax (Tx. only)	Shipping	Total paid
	8.25%