E.M.Computergraphic's USA FAX Order Form
Name:__________________________________________Telephone: (___)____________
Address:___________________________________________________________________
City:_________________________________State:____________________Zip______
Date:_________________________________
Payment:______________________________Make Payable to: Steve's Computer Tech
Cashier's Check or Money Order enclosed for $______________ C.O.D.' S add $6.00 (US Only).
Visa Mastercard AMEX Discover/Novus #_________________________EXP. DATE________
SIGNATURE_______________________________________
Email:_____________________
Quantity Item # Description Price TOTAL _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________
Total Shipping Charges:___________________ Total Amount for Items: _____________________ California Residents Add Local Sales Tax:____________________ TOTAL AMOUNT:____________________