ORDER SHEET
1.TYPE OF CREDIT CARD
VISA
MASTER@CARD
1.CARD NUMBER
P.DATE OF EXPIRATION
/
MONTH
YEAR
1.NAME
ZIP
1.PHONE
1.ADDRES
1.FAX
1.E-mail
(FILL IN CLEARLY)
-
-
-
(PRICE:TAX INCLUDED)
TOTAL PRICE
ITEM NUMBER
/
/
/
QTY.
/
PRICE EACH
TOTAL PRICE
/
/
/
/
/
/
/
/
