Logicware Company Store Order Form
| Logicware Company Store 20628 E. Arrow Hwy #6 Covina, California 91724 |
FAX: | 1 (626) 966 - 5701 |
| PHONE: | 1 (888) LOGIC - 45 (564-4245) 1 (626) 938-9108 |
Please print out this order form and fax or mail it to one of the above options.
| Ordered By: | Ship To: (if different from "Ordered By" address) |
| Name Address City State Zip Daytime Phone Number |
Name Address City State Zip Daytime Phone Number |
Mail Orders Only
Credit Card, Check or Money Order (Payable to Logicware Inc.)
* * DO NOT SEND CASH * *
FAX or Email Orders
Visa - MasterCard - American Express - Discover
| Account Number _ _
_ _ - _ _ _ _ - _ _ _ _ - _ _ _ _ Expiration Date _ _ / _ _ |
Cardholder's Name
________________________ Cardholder's Signature _____________________ |
| ITEM NUMBER | PRODUCT TITLE | PLATFORM | QUANTITY | PRICE EACH | TOTAL PRICE |
| Jazz Jackrabbit 2 | 29.95 | ||||
| SUBTOTAL | |||||
| SALES TAX (California residents only: 8.25%) | |||||
| SHIPPING & HANDLING | |||||
| TOTAL | |||||
| SHIPPING AND HANDLING * | ||
| Merchandise Total | Continental United States | International |
| Per Address | Per Address | Per Address |
| $10.00 - $29.99 | $5.95 | $12.00 |
| $30.00 - $49.99 | $6.95 | $14.00 |
| $50.00 - $74.99 | $7.95 | $16.00 |
| $75.00 - $99.99 | $9.95 | $18.00 |
| $100 and over | 10% of merch. total | $21.00 plus 7% of merch. total |
| AK, HI and U.S. Territories add $5.00 to the U.S. rates. | ||
| * For 2-Day Delivery, please provide street address and phone number. Oversized boxes ship UPS Ground. Orders to P.O. boxes will be sent by U.S. Mail. NO C.O.D.s, please. | ||