Fax Order Form
|
| This is not an online order form. This is a 3 page fax order form that can be filled out online, printed, and faxed to our order center to make purchases for the products listed below. All orders can also be placed by calling 800-736-3253. |
Lightweight Membership 8 pack - Product No.
CM08 |
Instructions for placing an order using the Fax Order Form: |
| 1. Complete the entire form. Any missing pieces of information such as phone numbers and dates of birth will delay your order and require further review. |
| 2. Once you have completed the form, review your input for any mistakes. |
| 3. Print this form to your printer by clicking "File" on the Menu Bar and selecting "Print". |
| 4. Once you have printed the form, read the statement at the end and sign your name. |
| 5. If your printed and signed form is complete and accurate, click on the "RESET" button at the bottom of the fax order form screen to erase your information. |
| 5. Fax the signed and completed form to Ale in the Mail at 949-206-9420. |
| 6. If you have any questions, or would like to confirm your order please call toll-free at 1-800-736-3253. |
| * IMPORTANT: This form will erase all of your information once you click on the "RESET" button. No information entered will travel over the internet. Information entered is not accessible to other users during your use, or after you have completed the form. |
Please provide your contact information:
Name Organization Street address Address (cont.) City State/Province Zip/Postal code Country Work Phone Home Phone FAX Date of Birth
Please provide the recipient's information:
Name Organization Street address (NO P.O. Boxes Please) Address (cont.) City State/Province Zip/Postal code Work Phone Home Phone Date of Birth
Please make your Product Selection:
For how many months would you like to run the membership?
(Only Monthly Club Selections apply)
In which month would you like the first shipment to be sent:
What would you like on your gift message (35 char. per line - 5 line max.)?
Choose one of the following gift message placement options:
Please select a billing option.
Please provide the following billing information:
BILLING Credit card Cardholder name Card number Expiration date
Shipping information
ALL ALCOHOLIC BEVERAGE PRODUCTS PURCHASED FROM ALE IN THE MAIL ARE SOLD IN THE STATE OF ILLINOIS AND TITLE PASSES TO THE BUYER IN ILLINOIS. Ale in the Mail makes no representation to the legal rights of anyone to ship or import alcoholic beverages into any states outside of Illinois. The buyer is solely responsible for the shipment of alcoholic beverage products. By placing an order with Ale in the Mail, I authorize Ale in the Mail to act on my behalf to engage a common carrier as a delivery service for my order. ALCOHOLIC BEVERAGES MAY BE SOLD AND DELIVERED ONLY TO PERSONS WHO ARE AT LEAST 21 YEARS OLD. IN PLACING MY ORDER, I REPRESENT TO ALE IN THE MAIL THAT I AM AT LEAST 21 YEARS OLD AND THAT THE PERSON TO WHOM DELIVERY WILL BE MADE IS AT LEAST 21 YEARS OLD. IN ADDITION, BY SIGNING THIS FORM I AM ACKNOWLEDGING THAT I AM NOT PLACING MY ORDER ON BEHALF OF A LAW ENFORCEMENT AGENCY.
An adult signature is required upon delivery and for this reason, we recommend having packages shipped to an office to ensure that a signature can be obtained.
I, the undersigned, have read, understand, and fully agree with the above statement.
Print Name |
__________________________ | Today's Date |
__________________________ |
| Signature | __________________________ | Date of Birth | __________________________ |
Fax the signed and completed form to 949-206-9420. Thank You.
