ORDER FORM
(PDF Version)
There are a few ways you can place your order.
Print this form, fill it out and fax it to 928-505-2229
Or you can, email your selections by name, color, size, quantity and cost to airchair@airchair.com.
Or call (928) 505-2226 during business hours 9 AM to 4 PM AZ time.
Or mail it to
Air Chair
2175 N. Kiowa Blvd. #101
Lake Havasu City, AZ 86403
Be sure to complete all shipping and payment information. A daytime phone number is helpful in case there are any questions regarding your order.
If you have a choice of color or size, please indicate a second choice if you would like a substitution if we're out of your first choice. If you do not want a second choice please indicate no substitutions.
CA residents add 8.75% sales tax for helmets and hydrofoil racks
AZ residents add 8.85% sales tax on all products.
Please Print Clearly
Name_______________________________ Phone (_____)_______-_______
Ship to
Address_______________________________ Fax(_____)_______-________
City_______________________________
State _________Zip Code___________
WWW.______________________ Email_____________________________
Credit Card Type (Circle) Debit/Discover /Visa/ Master Card/American Express/
Number _______________________________EXP Date___________
Authorization code___________ Found on the back of your credit card, it's the last 3 numbers
usually in the white area. For AMX it's the top number above the last 4 digits on the front.
Signature______________________________ Date_______________
You must provide billing address if different than ship to address on your credit card.
Address_______________________ City _______________State_____ Zip______
Please indicate ORIGINAL or PARTS where applicable
ITEM # DESCRIPTION COLOR QTY SIZE $ EACH $ TOTAL
_____ ___________________ _______ ______ _______ _______ ________
_____ ___________________ _______ ______ _______ _______ ________
_____ ___________________ _______ ______ _______ _______ ________
_____ ___________________ _______ ______ _______ _______ ________
_____ ___________________ _______ ______ _______ _______ ________
_____ ___________________ _______ ______ _______ _______ ________
_____ ___________________ _______ ______ _______ _______ ________
Shipping Costs________
(Calculated at time of shipping)
AZ Residents add 8.85% Tax________
CA Residents add 7.75% Tax________
For Helmets & Tower Racks
Total Cost ___________
Prices subject to change without notice.
Substitutions Acceptable or No Substitutions (circle one if applicable)
RETURN POLICY: Any unused item returned will incur a 15% restocking fee.
Please note: if you are sending a check be sure to contact Air Chair for shipping costs. They are calculated after order is placed because of the different costs to different areas, as well as different weights.
Some items are not always in stock and may require separate shipping charges.
Make Payment to:
Air Chair
2175 Kiowa Blvd N Suite 101
Lake Havasu City, AZ 86403