BRAND ATHLETICS SALES REP. KEN TUCKER           PHONE & FAX   503-357-8602                  EMAIL kent@brandathletics.net		SOUTHRIDGE HS BASKETBALL PLAYERS                                                          NIKE ORDER FORM
FOOTWEAR			STYLE	COLOR	QTY	SIZE	PRICE	Total
NIKE HYPERMAX			367180				$92.00
NIKE HYPERIZE			367181				$87.00
NIKE BLUE CHIP II			367182				$62.00
SHIPPING  INFORMATION			BILLING INFORMATION
NAME			TYPE OF CREDIT CARD		Total Amout Billed
STREET ADDRESS ( NO P.O. BOXES )			NAME ON CARD
CITY, STATE AND ZIP				CARD NUMBER				EXP. DATE
E-MAIL				SECURITY CODE #
TELEPHONE NUMBER