PO Box 1292
Dover, DE. 19903
Fax 302-678-5825
Order Form
DATE:
Print this page out for Fax or Mail orders.
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Order Form
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Billed To: (Address of credit card owner) |
Ship To: |
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PHONE NUMBER |
CREDIT CARD # | EXP DATE | CHECK #
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| QUANTITY | PRODUCT NO. | DESCRIPTION | UNIT PRICE | AMOUNT |
| SUBTOTAL SHIPPING & HANDLING TOTAL DUE |
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| $5.50 | ||||
Make all checks payable to: Atlascopy, Inc.
THANK YOU FOR YOUR BUSINESS!
http://atlascopy.com