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Text File  |  1999-01-25  |  2KB  |  78 lines
  1. Folder Remarker (product number 1762-1): order form
  2. ===================================================
  3.  
  4. Fax orders:
  5.  You should include an additional $2.50 per order.
  6.  Toll Free: 888-353-7276
  7.  Regular: 425-392-0223 
  8.  
  9. Telephone orders:
  10.  You will be charged an additional $3 per order.
  11.  Toll Free: 877-353-7297
  12.  Regular: 425-392-2294 
  13.  
  14. Postal Mail orders:
  15.  You should include an additional $2.50 per order.
  16.  Universal Commerce, Inc.
  17.  ATTN: Orders
  18.  PO Box 1816
  19.  Issaquah, WA 98027
  20.  United States of America 
  21.  
  22. Check or credit card order accepted
  23. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
  24. Note: for mailed orders, the checks need to be made out to Universal
  25. Commerce Inc. Checks should be drawn in US Funds.
  26.  
  27. Order Information
  28. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
  29.  
  30. Folder Remarker (1762-1)
  31. ----------------------------------------------------------------------
  32. Price: $15.00
  33. Quantity: ______
  34. Mail or Fax order price: $2.50
  35. Total amount ($U.S.): __________
  36.  
  37.  
  38. Payment Information
  39. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
  40. First Name:      _____________________________________________________
  41.  
  42. Last Name:       _____________________________________________________
  43.  
  44. Company:         _____________________________________________________
  45.  
  46. Street Address:  _____________________________________________________
  47.  
  48.                  _____________________________________________________
  49.  
  50. City:          _____________________________________________________
  51.  
  52. State/Province:  _____________________________________________________
  53.  
  54. Zip/Postal Code: _____________________________________________________
  55.  
  56. Country:         _____________________________________________________
  57.  
  58. Phone:           _____________________________________________________
  59.  
  60. Email Address:   _____________________________________________________
  61.  
  62. Payment:         __ VISA                           __ MasterCard
  63.                  __ American Express               __ Discover
  64.  
  65.                                        __ Check
  66.  
  67.  
  68. For credit card orders:
  69.  
  70. Name on Card: ________________________________________________________
  71.  
  72. Credit Card Number: __________________________________________________  
  73.  
  74. Expiration Date: month _______________ year (4 digits) _______________
  75.  
  76.  
  77.                 Signature : ____________________  Date: ______________
  78.