CoverSports Logo
800-445-6680


Order Form

Download our order form and fax to:
215-724-8706 or email as an attachment to
sales@coversports.com or fill out the form below.

Use this form to place an order*
Please only complete this form if you have already received pricing from our sales team and/or a price list. For pricing, please complete our Request a Quote form, Request a Catalog form, email sales@coversports.com, or call us at 800-445-6680.
When your order is entered into our system, an acknowledgement copy will be faxed or emailed for your review.
Please provide contact information below.
Do you have an existing account?        Yes    No 
If not, and you would like to open an account with credit terms, please complete the Credit Application form.
*Organization Name: 
*Contact Name:
*Customer Phone:
*Date
Customer Fax:
PO#:
*Customer Email:
Referred By (Internet, Print Ad, Colleague, etc.):
Ship to Address: Bill to Address:


*Address   *Address  


*City   *City  


*State   *State  


*Zip   *Zip  
Payment: If you are paying with a credit card, please provide your phone number and someone will contact you for your credit card information.

*Product/Product Code (if known)  

*Quantity  

*Color  

*Size  

Features/Notes 

Price 

Subtotal 

Shipping costs (if provided) 

 
Total  
 

Additional Comments: 

Would you like to be added to our mailing list for occasional promotional and informative emails?   Yes      No 

How did you hear about us?
  Internet Search
  Print Ad
Online Buyers Guide
Email Blast
Direct Mail Piece
Colleague
Other  



 

*Mandatory fields
Privacy Policy:
Your information will not be sold, exchanged, transferred or given to any company for any reason, without your consent, other than for the express purpose of delivery the purchased product or service requested by the customer. If you make a request for information, we collect and store the personally identifiable information needed to fulfill your request (typically your name, mailing address and email address). You may receive periodic emails from Humphrys CoverSports if you elected to be placed on our mailing list. If you do not wish to receive these emails you can request that you be removed by sending an email to sales@coversports.com.