Order Form

Directions:

1. Fill out this on-line form.
2. Click on the "Prepare To Print" button at the bottom.
3. Review the printable results for accuracy
4. If corrections are needed, use the "back" button of your browser to redisplay the form, make the needed corrections, and click on the "Prepare To Print" button at the bottom again.
5. Use your browser to print the completed order form and fax or mail to:

Dept. 4195
SAE
400 Commonwealth Dr.
Warrendale, PA 15096-0001 USA
Telephone (412) 776-4970
Fax (412) 776-0790
NOTE: Some companies will not deliver mail to your business address. Please list your home address if so.
Ship To:
Home Address
Business Address Individual :
Mail stop (if applicable) :
Job Title :
Company Division/Department :
Company Name :
Street Address :
City :
State or Province : Country : Zip + 4 or Postal Code :
Telephone: Fax : e-mail :
If billing address differs from shipping address, please specify:
Individual :
Mail stop (if applicable) :
Job Title :
Company Division/Department :
Company Name :
Street Address :
City :
State or Province : Zip + 4 or Postal Code :
Country : Telephone : FAX :

Order Item Detail
Qty Order# Product Description Price Each
Additional Charges
*Order Amount Handling Charges
$0.01-$50.00 $ 4.50
$50.01-$125 $ 7.50
$125.01-$1000 $ 9.50
$1000.01 or more $15.00
Overseas Surcharge $10.00
PA residents (unless a tax exemption certificate is on file with SAE) 7% sales tax (6% state;1% county)
Canadian residents 7% goods and sales tax (GST)

Prices are subject to change without notice; all orders will be filled at current prices.

Customer No. :
SAE Membership No. :
(You must have a valid membership number to obtain member discount prices where applicable.)
Click on the appropriate method of payment:
:Check or Money Order Enclosed



:American Express
:MasterCard
:Visa
:Diner's Club
:Discover

Account No. : ________________________________
Expiration Date (required) :
Signature: ________________________________





:Bill Us
Purchase Order No. :

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