TRAILER GIANT CUSTOMER ORDER FORM   FAX TO: 1-229-423-2217

Customer Name ____________________________________Order #__________________

Address __________________________________________________________________

City _________________________ State ______________ Zip ______________________

Phone _________________________ Email ______________________________________

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Trailer Type (circle one)   Cargo   Horse   Utility          Brand __________________________

Size ________________ Color _____________________ Year ______________________

Option 1 ______________________________________   $ ________________________

Option 2 ______________________________________   $ ________________________

Option 3 ______________________________________   $ ________________________

Option 4 ______________________________________   $ ________________________

Option 5 ______________________________________   $ ________________________

Agreed upon price for trailer with all above options                 $ ________________________

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Payment type (circle one)

Credit Card:     VISA       MC       DISCOVER       AMEX

Name as appears on card _____________________________________________________

Address credit card comes to __________________________________________________

City _________________________ State ____________________ Zip ________________

Card # _______________________________________ Exp. Date ____________________

Security Code (back of card) _______________ Customer Support # ___________________

Certified Cashier's Check or U.S Postal money order  Check # _________________________

Personal or Business/Company check    Check # ___________________________________

Western Union wire transfer transfer # ____________________________________________

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Authorized Signature ____________________________________ Date ________________

By signing the above I agree all of the information to be true and accept all terms and conditions.
Trailer Giant is not held responsilbe for any illegal or fraudulent charges for above information.