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- WinNavigator (product number 1639-1): order form
- =========================================================
-
- Mail this form to: Universal Commerce, Inc.
- ATTN: Orders
- PO Box 1816
- Issaquah, WA 98029
- United States of America
-
- Or fax it to: 1 888 353-7276 (U.S. and Canada; toll-free)
- 1 425 392-0223 (other countries; regular)
-
- Or just call: 1 877 353-7297 (U.S. and Canada; toll-free)
- 1 425 392-2294 (other countries; regular)
-
-
- Check, money order, purchase order or credit card order accepted
- ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
- Note: for mailed orders, the checks need to be made out to Universal
- Commerce Inc. The product ID (1639-1) should be mentioned on the
- "memo" of the check. Checks and money orders should be drawn in US
- Funds. A purchase order must be faxed or mailed to the address listed
- above with all necessary information including billing information.
-
-
- Order Information
- ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
-
- WinNavigator (1639-1) Price/Unit Quantity Total
- ----------------------------------------------------------------------
- 1 - 100 Units $29.00 ______ __________
-
- Mail or fax order $2.50 __________
-
- TOTAL AMOUNT ($U.S.) __________
-
- Note: if you place an order by fax (with credit card), or pay with
- check, money order or purchase order, please include additional
- $2.50 (see above). Otherwise, your order will not be processed. If you
- place an order by phone, you'll be charged for additional $3. For
- online orders, there are no additional charges.
-
-
- Payment Information
- ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
- First Name: _____________________________________________________
-
- Last Name: _____________________________________________________
-
- Company: _____________________________________________________
-
- Street Address: _____________________________________________________
-
- _____________________________________________________
-
- City: _____________________________________________________
-
- State/Province: _____________________________________________________
-
- Zip/Postal Code: _____________________________________________________
-
- Country: _____________________________________________________
-
- Daytime Phone: _____________________________________________________
-
- Fax: _____________________________________________________
-
- Email Address: _____________________________________________________
-
- Payment: __ MasterCard __ VISA __ AMEX __ Discover
- __ Check __ Money order __ Purchase order
-
-
- For credit card orders:
-
- Name on Card: ________________________________________________________
-
- Credit Card Number: __________________________________________________
-
- Expiration Date: month _______________ year (4 digits) _______________
-
-
- Signature : ____________________ Date: ______________
-