G T THUNDER 

PrePrint Background Order Form 

Instructions:  Print out this form, fill in all the information, and fax to 330-674-2437. 

Ship to: 

GT Thunder

6748 TR 630

Millersburg, OH  44654 

Return Address and Information:

Name:________________________________________________________________________

Address: _____________________________________________________________________

City:________________________________________State:______ Zip:__________________ 

Phone:__________________________ 

Model:__________________________ 

Back Ground Color:__________________________ 

Number Color: _______________________________

Number: ____________________________________ 

Name as printed:________________________________________________________________

Credit card #___________________________________________________________________

Exp. Date_________________  Security Code________________