Software USA - Software Order Form
Shipping and Billing Information (Please Print)
Name
______________________________________________________________
Address
______________________________________________________________
City/Town
______________________________________________________________
State/Province Postal/Zip Code
_____________________________ ________________________________
Country
______________________________________________________________
Phone Number Member #
(______)_____________________ ________________________________
Payment Methods (Credit Card ONLY)
[ ] MasterCard [ ] Visa [ ] American Express [ ] Discover
Credit Card Number:_____________________________________________
Expiration date:______/______/______
Signature:______________________________________________________
Mail completed form to:
Software USA
Attn: Software Catalog
9909 Huennekens Street - Suite 200
San Diego, CA 92121-2929
Telephone: (619) 455-9600 or Fax this form to: (619) 455-0038
Software Titles Ordered
Quantity - Program Title - Price________ - ______________________________________________________ - ______________
________ - ______________________________________________________ - ______________
________ - ______________________________________________________ - ______________
________ - ______________________________________________________ - ______________
________ - ______________________________________________________ - ______________
________ - ______________________________________________________ - ______________
Subtotal $_____________
Sales Tax $____________ (7.75% - CA residents only)
Shipping $_____________ [ $3.50 for every two titles ordered ]
Total $________________