5Y6    Online Special Order.                               
 
Press "Submit Order" at the bottom of the page, or print this page and  FAX to:  561 892 0712
Catalog N.  Product Description           QTY Unit Price Tot.Price
      SUB TOTAL.
Please Include  Sales Tax where applicable 
USA  * Shipping UPS Ground
 * International Shipping Charges, will be confirmed via FAX or E-mail.   TOTAL AMOUNT. $
   The information your submitted will be maintained confidential and not sold to third parties
Company:
Name:
*E-mail:
Phone number:
Fax number:
Billing address:
Shipping address : if different from above):
Special instructions
Confirm your Email   :
 Secure invoice will follow 
 Payment options, Credit or Debit Cards, ECheck, PayPal.          
 NO CREDIT CARDS on, Special orders or international orders
    

    Thank You. Return   
* International Payment and Shipping Charges, will be confirmed via E-mail. We Can NOT deliver to PO Boxes.  Terms
   Sales tax will be added to your order if required by your state,
   NO CREDIT CARDS on Discounted items, Special orders or international orders,
   Wire transfers and company checks are accepted, No returns or order cancellations on special orders or software
   Regular UPS ground or Federal Express, For Rush shipping please include a note in "Special instructions"

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