Note! Form information with an "
*
" must be completed
Full Name:
*
First Name
Last Name
Bowling Center Number:
*
Mobile Number: (Preferred)
E-mail:
*
Bowling Center Name:
*
Shipping Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type of Pinsetter and Model:
*
BRC "A-2" or AMF 82-70 etc.
Type of Automatic Scoring:
*
Twelve Strike or Brunswick AS-90 etc.
Quantity | Product ID or Part ID:
*
Purchase Order:
Purchase Order Number
Credit Card Information
Please note your card will not be charged until your order is shipped.
Name on card:
*
First Name
Last Name
Card Number:
*
First 8 Numbers
*
Last 8 Numbers
Expiration Date:
*
4 Numbers
CV Code:
*
3-4 Numbers on back of card
Credit card bill to address
Only fill out if different then shipping address.
Bill to address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Enter the message as it's shown:
*
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Should be Empty: