PACIFICA FAIRWAYS ORDER FORM
NOTE: All information given to us at PACIFICA FAIRWAYS is kept strictly confidential. We do not sell, trade, or distribute this information to anyone.
THIS IS A SECURE ORDER FORM
THE INFORMATION GIVEN HERE IS ENCRYPTED
NO ONE ELSE SEES THIS INFORMATION

Name
Address
City State Zip code
Home Phone # Work #
E-mail
Height Ft. In. Swing speed if known mph
QuantityClub(s)
QuantityClub(s)
QuantityClub(s)
QuantityClub(s)
Shaft flex
Shaft
Sub total
Volume discount for 2 or more clubs deduct 10%
Total
Shipping / Handling Add $12.75 for U.S. and Canada
California residents add 8.25% state tax
Total order
Credit Card
Name as it appears on card
Credit Card Number
Exp. date
Comments or special instructions

AFTER SUBMITTING YOUR ORDER 
PLEASE WAIT A FEW MOMENTS FOR YOUR ORDER CONFIRMATION AND THEN VERIFY THAT ALL OF THE INFORMATION YOU SUBMITTED IS CORRECT. THANK YOU