Please please fill the following fields to validate.

BandanaMan Secure On-Line Order Form

BANDANAMAN™

WHOLESALE ONLY SECURE ON-LINE ORDER FORM

Please fill out all necessary fields and submit the secure form. We will confirm your order via E-mail. We do not trade, sell, give away,
or in any other way share your information with any other person or company.

Please Double Check Your Information! 25% of all orders contain wrong information,
particularly mis-spellings on E-mail addresses, shipping address and wrong or incomplete credit card numbers.

* Designates Required Information

SHIP TO:

*Name:

Company:

*Address: (No PO or APO Boxes):

*City:

*State/Province:

*Zip/Postal Code:

*Phone Day:

Fax:

*E-mail:

Do you have one of the Following:
Resale Number (RN#) Fed Tax ID 501C Documentation:
Place Information Here:

BILL TO (if different than the Ship To address):

Name:

Company:

Address: (No PO or APO Boxes):

City:

State/Province:

Zip/Postal Code:

Phone Day:

Phone Evening:

*SHIPPING METHOD:
Our standard shipping method is FedEx Ground
Standard Shipping Method (FedEx Ground)
FedEx Overnight FedEx 2nd Day FedEx 3rd Day
Other (please specify in box the box to the right)

OTHER SHIPPING / SPECIAL SHIPPING INSTRUCTIONS: (Use this box to specify your preferred shipping method and/or special shipping instructions).
None

*METHOD OF PAYMENT:
Please Note: Residents of Nevada will have Sales Tax added

Do not use autofill in the boxes. Autofill can add numbers to other boxes on the order form.
Credit Card (see below) Money Order (US$ funds)
Cashier's Check / Bank Draft (US$ funds)

Credit Card: Card #:
Security number on back#:

Expiration Date:

*PRODUCT ORDER:
PAISLEY'S (Enter Quantity by Dozens. Example: 50 = 50 dozen bandanas)
Orange Paisley Red Paisley White Paisley	Black Paisley Light Blue Paisley Purple Paisley	Navy Blue Paisley Royal Blue Paisley Silver Paisley	Brown Paisley Green Paisley Light Pink Paisley

BLANKS (Solids) (Enter Quantity by Dozens. Example: 50 = 50 dozen bandanas)
Black Blanks Red Blanks Royal Blue Blanks	Yellow Blanks Light Blue Blanks	Navy Blue Blanks Light Pink Blanks Organic Natural Blanks	Orange Blanks Purple Blanks Gray Blanks	White Blanks Cocoa Brown Blanks Forest Green Blanks
SPECIALTY (Enter Quantity by Dozens. Example: 50 = 50 dozen bandanas)
Yellow Tie dye Blue Tie Dye	Digital Desert Camo Woodland Camo	Cowhide Purple Tie-Dye	Desert Sand Camo

All orders are confirmed by BandanaMan within 24 hours. Please email us if you have any questions.

PLEASE DOUBLE CHECK ALL INFORMATION!