Digital Products
Company |
Order by telephone at xxx-xxx-xxxx, or print this form and Fax to xxx-xxx-xxxx, or mail to address shown on left. |
| NAME: | DATE: / / |
| COMPANY: | |
| ADDRESS: | |
| CITY: | |
| STATE: | |
| ZIP/ POSTAL CODE: | |
| COUNTRY: | |
| PHONE: | |
| FAX: | |
| E-Mail: | |
| PO# or Ref#: |
QTY |
DESCRIPTION |
PRICE EACH |
TOTAL PRICE |
Sub Total |
|
Shipping Charges |
|
CA Local Sales Tax |
|
Total Charges |
[ ] Check [ ] Money Order [ ] Charge Card (Visa/MC/Disc/Amex)
Charge Card Number
________-_________-_________-_____________ Expiration Date
______ / _______
(MM/YY)
Printed Card Holder Name(s) ________________________________________
Signature _________________________________
Card Card Validation Number (see CCV details on right). __________________________
Card Holder billing address _____________________________________________________________________________________
All prices shown in USA dollars. USA domestic Ground Shipping is $14, 3-8 days estimated delivery time; For other shipping options please contact us before placing your order. California deliveries please add CA sales tax. Visa, MasterCard, Discover, and American Express accepted. Company checks, personal checks, and money orders ok. Allow 7-10 days for bank clearance on checks. No COD's. Any import duties, taxes, tariffs or brokerage charges associated with international shipments shall be the customer's sole responsibility.
|
Mail or Fax your
order to: |
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