EmailMe Form - Capitol Varsity Dealer Information

Order # *

PO # *

Helmet Tracker Summary Email *

Dealer Name *

Dealer Email *

Return Date *

School Name *

Shipping Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Number of Helmets *

Incoming Helmet Color *

Facemask Color *

Helmets: Choose One *

Color *

Paint Code *

Match Sample Included? *

Return Rejected Helmets? *

Facemasks: Choose One *

Re-dip Facemasks *

Color *

Chin Straps: Choose One *

Type *

Color *

Jaw Pads: Choose One *

Size *

Color *

Number of Shoulder Pads *

Shoulder Pads: Choose One *

Jersey Quantity

Jersey Color *

Pants Quantity *

Pants Color *

Notes: