From agaccess@davis.comSat Dec 30 18:29:52 1995 Date: Fri, 29 Dec 1995 23:28:36 -0700 From: agaccess@davis.com To: Larry London Subject: agAccess Email Order Form ***************************************************************** * agAccess Email ORDER FORM * ***************************************************************** To make an order via Email, please fill in the information below, or call us at 916-756-7177 to make other arrangements. _________________________________________________________________ ITEM # | Title | Qty | Price | Total | _________________________________________________________________ | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | _________________________________________________________________ **************************** | | * WHEN ORDERING UPS RATE * Subtotal|_______| * 1 Book $4.00 ea.* CA Residents add 7.25% Tax |_______| * 2-4 Books $3.50 ea.* Shipping (see chart left) |_______| * 5-10 Books $2.50 ea.* |+ | * 11-25 Books $2.00 ea.* TOTAL |_______| * 26-100 Books $1.50 ea.* * Over 100 Books $0.75 ea.* **************************** Note: Insured delivery costs additional $4.00 per order. Airmail Overseas costs $10.00 ________________________________________________________________ ** ORDERED BY: ** Name: Company: Address: City: State: Zip: Country: Phone: Email: ________________________________________________________________ ** SHIP TO: ** Name: Company: Address: City: State: Zip: Country: Phone: Email: ________________________________________________________________ ** BILLING ** ____ Visa ____ Mastercard ____ Check / Money Order (print this form for fax or mail ordering) __________________________ Credit Card Number __________________________ Expiration Date (MM/YY) __________________________ Name (as it appears on your credit card.) __________________________ Signature (only for mail or fax ordering) ***************************************************************** If you do not want to send your credit card number via email, or would prefer to pay by check: 1) Fill out all of the information including your credit card number. 2) Print the form 3) FAX the form to us at 916-756-7188 4) Or, mail the form (with a check if you do not want to use a credit card) to: agAccess P.O. Box 2008 Davis, CA 95617 U.S.A. *************************** END ********************************