CD-ROM Access Order Form

CDAccess.com Order Form

Name: _______________________________________________________

Address: _______________________________________________________

_______________________________________________________

City: _______________________________ State: ____________

Country: _______________________________ Zip Code: ____________

Phone # (Required): _____________________

FAX # (Optional): _______________________

I would like to purchase the following items from CD-ROM Access:

ITEM QUANTITY PRICE

[add more lines if necessary]

SUB-TOTAL ________

Tax (8.75% for Tennessee Residents only) ________

Shipping (Per Order - SEE BELOW) ________

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DOMESTIC ORDERS ONLY (Within the United States of America)

FLAT RATE via MEDIA MAIL: $3.99.

FLAT RATE via PRIORITY MAIL: $6.99

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INTERNATIONAL ORDERS ONLY:

Please check our web site for exact pricing.

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FINAL TOTAL ________

Payment by (check one): VISA ___ M/C ___ DISC ___ AMEX ___

Card Number (see below): ________________________________

Expiration Date: __________ <---- IMPORTANT!

Security Code (3 or 4 digits on back of card): __________ <---- IMPORTANT!

Check ___ M/O ___

If ordering by Check or Money Order *please* make sure the product is in stock before you place your order!

All prices are in US Dollars. Please ask before sending any checks or money orders unless it is in US Dollars drawn on a US bank.

Our Mailing Address is:

CDAccess.com
6870 Comstock Road
College Grove, TN 37046

Voice (615) 595-0950, FAX (615) 595-1599, Toll Free (800) 959-5260

Email: sales@cdaccess.com