Gathering of the Juggalos 2005 Order Concern Form

Please provide the information below accurately so that we can resolve this issue quickly and efficiently. All fields regarding your method of order are required.

Your Full Name:
Your Phone Number:
Your Email Address:
This order was paid for with:
Order Number:
This is a 5 digit number sent in your confirmation email that you received when you placed your order.
Date Ordered or Mailed:
Month:
Day:

If this was a credit card order, fill out the following information:

Last 4 Digits of Credit Card Used:

Summary of Problem with Order:
Please enter any concerns that you may have pertaining to your order with Gathering of the Juggalos 2005.