Recycle Free Inc - Registration

Instructions:
Read this form carefully. There are three (3) simple tips to remember.

1. Please complete all mandatory fields.
2. Choose the products you desire to purchase.
3. Select the correct shipping method and credit card option.

*Mandatory Selections

	Organization Name and Contact Information
Organization:	*
Contact:	*
E-Mail address:	*
Alternate Contact:
Phone:	*
Alternate Phone:
Fax:
	Shipping Address
Street Address:	* Please do not use PO Box or PMB.
Suite / Room Number:
Mail Stop:
City:	*
State / Province:	*
Zip:	*
Country:	*
	Billing Address (if different than shipping address)
Street Address:	*
Suite / Room Number:
Mail Stop:
City:	*
State / Province:	*
Zip:	*
Country:	*
	Select Your Product Below
	Mini ATV - The Buzzz $749 after $50 INSTANT SAVINGS** Reg. Price $799 Enter Quantity:
	Mid-Size ATV - The All-Terrain Electric Vehicle $2199 after $200 INSTANT SAVINGS** Reg. Price $2400 Enter Quantity:
	Balamar - Seascooter $219 after $30 INSTANT SAVINGS** Reg. Price $249 Enter Quantity:
	Zappy3 Pro Electric Scooter w/ 2 Batteries $799 after $50 INSTANT SAVINGS** Reg. Price $849 Enter Quantity:
	Zappy3 Original Electric Scooter $469 after $30 INSTANT SAVINGS** Reg. Price $499 Enter Quantity:
	Zappy3 EZ Mobility Scooter $519 after $30 INSTANT SAVINGS** Reg. Price $549 Enter Quantity:
	Mud'E Dirt Bike $669 after $30 INSTANT SAVINGS** Reg. Price $699 Enter Quantity:
	Shipping Method
Shipping Method:	*
	Payment Information
Card Number:	* VISA, MasterCard, American Express, Discover
Expiration Date:	* (mmyy)
Security Card Code:	* VISA and MasterCard users should see a 3-digit code following the 16-digit account number on the back of your credit card. American Express Users should see a 4-digit security code printed on the front of your card just above the main credit card number.
	Follow-Up / Comments
What you Should Know:	All shipments are delivered by standard ground delivery via UPS, FedEX, DHL or similar carriers using the most economical method as determined by Recycle Free. Standard shipping 5 - 15 business days. All orders are shipped FOB Newbury Park, CA. Larger items may require freight shipment. Expedited freight is not offered on the ATV's or Dirtbike. We do not deliver to PO Boxes or PMB's. Some items may ship separately. Delivery dates are not guaranteed. Subject to availability. We are required by law to charge sales tax on all shipments to a California address. Shipments outside of California are not subject to sales tax. All returns require a return authorization and are subject to a 15% restocking fee. Each state has their own legal ordinance and classification for electric ATV's and scooters. Check your local city and state laws. Always wear a safety helmet and obey all traffic laws.
Telephone Follow-up:
Please list any comments, questions or feedback.

*Required
**Subject to Availability and Color

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