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order.txt
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1992-11-11
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2KB
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47 lines
-----------------------------------------------------------------------------
KwikDraw Order Form
The Human Interface
902 94th St. S.E.
Everett, WA 98208
(206) 348-9043
-----------------------------------------------------------------------------
Name: ____________________________________________________________________
Address: ____________________________________________________________________
____________________________________________________________________
City: _____________________________ State: _________ Zip: ________________
Country: __________________________________ Phone: __________________________
Qty: _______ x $37.95 = $______________ Shipping Rates
Shipping (see rates) = $______________ U.S. & Canada:
Qty 1-3: $3.00
Charge card fee ($2.00) = $______________ Qty 4-6: $5.00
Qty 7-10: $7.00
C.O.D. fee ($3.00) = $______________
overseas:
Total = $______________ Qty 1-3: $6.00
Qty 4-6: $10.00
Qty 7-10: $14.00
please check one:
____ Please ship C.O.D. (U.S. only, $3.00 additional charge)
____ Check enclosed (if you are not from the U.S. or Canada and your check
is drafted on a local bank then please convert to your local currency)
____ Mastercard: _________________________________________ Exp: ____________
____ Visa: _______________________________________________ Exp: ____________
Signature: __________________________________________________________________
please allow 3 weeks for delivery