Digital Products
Company |
Order by telephone at 916-985-7219, or print this form and Fax to 916-985-8460, 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. 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. Net 30 terms to qualifying institutions (USA only). 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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