Fanatic Fantasy Football Virtual Order Form

Order Form: Phone, Fax, Mail

	Phone Orders: 702-382-3135 \| Fax Orders: 702-441-0810
	Mail Orders: FanaticFantasyFootball.com LLC 5795 S Sandhill Rd., Suite F, Las Vegas, NV 89120 Fill in the form, print it, then phone, fax, or mail order to us.
Currency:
Total Amount:	Required Invalid format.The entered value is less than the minimum required.The entered value is greater than the maximum allowed.
Item Name:
Items Ordered:	Use this area to enter each league you wish to purchase a team in. Required
Billing Information:
First Name:	Required
Last Name:	Required
Card Type:
Card Number:	Required Invalid format.Minimum number of characters not met.Exceeded maximum number of characters.
Expiration Date:	Year:
Card Security Code:	Required 3 Digits from back of card Invalid format.Minimum number of characters not met.Exceeded maximum number of characters.
Address Line 1:	Required
Address Line 2:	Apt or Box # if applicable
City:	Required
State:
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Email:	Required Invalid format.
Home Telephone:	Minimum number of characters not met. Required 10 digits only no dash Exceeded maximum number of characters.
	I authorize FanaticFantasyFootball.com LLC to bill my credit card for this order.
Print Name:	Required Full Name Printed
Signature:	Required Full Signature
Date:	Required
	Missing or incomplete information will delay your order.
	All orders must clear the bank before you'll be allowed accesss to your league.

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