Rocket Roger's Web Orders

This is a secure order form!!!!!!

SHIPPING INFORMATION

Please provide the following shipping information:

Last Name
First Name

M.I.

Street Address

Address (cont.)

City State

Zip/Postal Code

Your Victory Motorcycle is a

Order Form

Quantity

Part #

Description

Sales Price

*Calculate your own Total* !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! All Products will be charged with a 5% sales tax, and a shipping charge of no less than $15.00. 20% restocking fee on all returned parts and accessories. No return on electrical parts or on sale items. No Returns after 10 days. Returns for store credit only.	Total Parts
	5 % Sales Tax
	Shipping min. $15.00
	Grand Total

SHIPPING

UPS Ground 2 Day Air Next Day Air

Credit Information

Card Number

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This Card is a..... Expiration date

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