Blank Stock kickstand pads have a variety of uses.
ORDER FORM
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Custom Imprint Order Form | Blank Stock Order Form | Singles Order Form
Product Requests
kickstand pads, kickstandpad, motorcycle kickstand plates pucks solid artistic custom imprint sidestand support
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Quantity 50-250 500 1,000 2,500 5,000 10,000+
All Plastic Colors
$ .90
$ .85
$ .80
$ .75
$ .70
$ .65
50 Piece Minimum Order
All Prices U.S. Dollar

SHIP TO INFORMATION
Company:
Address:
City, State, Zip:
Phone # (w/AC):
Contact Person:
Date of Order:
_________________________________________________
_________________________________________________
_________________________________________________
______________________ Fax #:_____________________
_________________________________________________
__________________ Email Address:_________________

Enter Quantities of Colors Desired
Plastic Color Black   Red  Orange  Lime   Pink  Yellow White Dk Blue Lt Blue  Purple   Natural   TOTAL 
Quantity   + + + + + + + + + + =

PAYMENT METHOD
Check # _____________
Credit Card # _______________________________ Expiration Date: ____/_____
V-Code__________* Check Type _____ American Express   _____ VISA
*(The V-Code is the last three- or four-digit number located on the back of your credit card on the signature panel.) of Card _____ Discover   _____  Master Card
Authorized Signature:________________________________________    
BILL TO INFORMATION
Name on Credit Card:
Address:
City, State, Zip:
_________________________________________________
_________________________________________________
_________________________________________________

ORDER COST
Quantity of color pieces _______ @ $_______ = $ ____________
Sub Total $ ____________
State of IL add 8.75% sales tax $ ____________
Shipping/Handling $ ____________
TOTAL $ ____________

MAIL or FAX to:
Your source for The Original Motorcycle Coaster.
515 S. Tanner St., Rantoul, IL 61866
1-800-CROWN-IT (276-9648) Fax: 888-704-4687
E-mail: sales@crownadv.com

Rev. 9/25/2012 PDKSN