Bayside Uniforms
Fax/Mail Order Form

Print this form, and fax it or mail in with your payment
Your Information
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Name:     
Address  
City:          State:
Zip Code:   
Telephone: 
E-Mail:  

Ship to: (if different)
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Name:      
Address   
City:           State :
Zip Code:

Quantity Item Number & Description Color Size Price (each) Total
           
           
           
           
           
           
           
Sub Total   
(VA. residents only) Sales Tax: 4.5%  
Shipping and Handling (see chart)  
Grand Total   

Print and Mail this form to:
Bayside Uniforms
P . O . Box 796
Exmore, VA. 23350-0796

Toll free Phone #
1-(888)-874-6463

24- Hour Fax  Order Line
1-757-442-4779

         I am paying by check or money order (Make checks payable to Bayside Uniforms)
         I am charging this order         Visa          MasterCard          Discover Card
        Card number:                                            Expiration Date:                           
        Signature:                                             Name on Card:___________________ 

         Customer Phone Number:_____-_____-_________ Day        Evening Phone:_____-_____-__________

__     E-mail address:___________________