Please print this form and mail in your advertising order. (Not for use on-line) Use your browser's BACK button to return to The Fiero Store.


The Fiero Store
 SALES FORM
ORDER DESK :
1-800-Fiero-GT
 TECH LINE :
(860) 684-6762
PO Box 538
24 West St.
Stafford Springs, CT 06076

TO ENSURE PROMPT DELIVERY, PLEASE TYPE OR PRINT CLEARLY


SELLER:
 BILL TO:
CUSTOMER #:
 CREDIT CARD ORDERS ONLY
NAME:
 NAME ON CARD:
CHECK #:
 ADDRESS:
ADDRESS:
 CITY:
CITY:
 STATE:ZIP:
STATE:ZIP:
 CONTACT PHONE: ()
PHONE: ()
 Trans Type: AUTO 4-Spd 5-Spd
E-MAIL ADDRESS: ENGINE SIZE:


Please COMPLETE the information below to ensure the best possible support for your advertised Fiero or Fiero Parts Sales! Include upto 3 photos as STANDARD, extra photos $5.00 each.
ASKING PRICE:
YEAR & MODEL:
MILEAGE:
INTERIOR COLOR/MATERIAL:
EXTERIOR COLOR/TRIM:
* OPTIONS:
(A/C, sunroof, spoiler, stereo, etc)
* DESCRIPTION:
(upgrades to the car, current condition, etc)
* Attach additional pages if necessary (maximum 300 characters)


CARD #:
 Number Box Basic Advert Cost
 $39.95
Expiration Date:
 // Extra Photos
 $
Card Holder Signature
 CT Res. add 6%
 $
Bank Issuing Card
 Total Due
 $


FOR YOUR PROTECTION, WE THOROUGHLY INVESTIGATE THE VALIDITY OF ALL CREDIT CARD ORDERS!
If paying by check please allow extra time for clearance!
Please view the "Terms and Conditions" on the For Sale Page of our Web Site.