Order Form

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, or call us at 855-960-5480.

When your order is entered into our system, an acknowledgement copy will be faxed or emailed for your review.


Please provide contact information below.

  • MM slash DD slash YYYY
  • Ship to Address

  • Bill to Address

  • Payment

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

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.