FAX/POSTAL ORDER
FORM
QualityMathProducts.com
Excellence in Learning
Use this form if you do not wish to place your credit card
numbers on the Internet.
"Please print out this form and either post or fax it to us"
| Your Name | ................................................................. |
| Address line 1 | ................................................................ |
| Address line 2 | ................................................................ |
| City | ................................................................ |
| State/Province | ............................. |
| Post/Zip Code | .............................. |
| Country | ................................................................. |
| Phone | ................................................................ |
| Fax | ................................................................. |
| Email Address | ................................................................. |
| *Qty. | *Name | *Description | *Price | *Total | |
| ......... | .................................... | ....................................................... | .......... | .......... | |
| ......... | ................................... | ...................................................... | ........... | .......... | |
| ........ | .................................... | ....................................................... | ........... | ........... | |
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| ......... | ................................... | ....................................................... | ........... | ........... | |
| ......... | ................................... | ....................................................... | ........... | ........... | |
| - | ................................... | ...................Shipping....................... | ........... | ........... | |
| Total | ................................... | ....................................................... | ........... | ........... |
Credit Card Details: We accept Mastercard, American Express, Discover and Visa. (You may also pay by cheque or money order.)
Name on card..................................................................................
Card Type...................................................CARD CHECK number..........(last three digits of number on the back of your card or four on front for American Express)
Card Number:.............................................................Expiry date: (mm/yy)....................... Amount:...............
Postage and handling is $6.95 per order in USA. International orders - please call for a quote.
All orders are processed in US
currency.
Our address:
Quality Math Products
GNHC Enterprises, LLC.
P.O. Box 241, Durham NH 03824 - USA