Gabe Garcia Official Store Fax/Mail Order Form

Gabe Garcia Official Store Fax/Mail Order Form
Please print out this form and enter the products you would like to purchase and mail/fax to:
Fax: 830.772.3123
Mail to:
Farm Road Records
P.O. Box 1831
Lytle, Texas 78052

Please complete the following sections and your order will be processed within 3 business days:

Name:_____________________________________

Shipping Address

Address:___________________________________

City:__________________ State:______________ Zip:_________________

Cardholder Name:(exactly as it appears on credit card)______________________________________________

Credit Card Number:__________________________________ Expiration Date:_____________ Security Code: ________

Billing Address (if different than shipping address)

Address:___________________________________

City:__________________ State:______________ Zip:_________________

Products Desired

1)__________________________________________________ Quantity_______

2)__________________________________________________ Quantity_______

3)__________________________________________________ Quantity_______

4)__________________________________________________ Quantity_______

5)__________________________________________________ Quantity_______

6)__________________________________________________ Quantity_______

Customer Confirmation:

Email Address:______________________________

Phone Number :_____________________________

Thank you for shopping with us!