Order Form: ACTIVATORS & ACCESSORIES
| FAX or mail order to: |
Ship to: |
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Company or School: |
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| Contact Name: |
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| Street Address: |
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| City, State, ZIP: |
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| Daytime Phone: |
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| Email Address: |
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Payment Method (select one) info |
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| Purchase Order #: |
Credit Card |
Check |
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| Tax Exemption Number : Illinois Customers Only |
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Special Instructions:
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Sub-Total |
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Shipping info |
$__________ |
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USA (lower 48) (ground delivery) |
$5 | |||||
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Canada, APO, Alaska, Hawaii |
US$15 | |||||
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EXPEDITE or COLLECT Shipping costs + $5 expedite processing fee |
call | |||||
| International | call | |||||
Sales Tax |
$__________ |
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Total |
$__________ |
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