K2RF Fax Order Form

Instructions: Print this page on your printer, complete information including Credit Card  number and expiration date, fax to:  503 - 642 - 5678 

Ship / Bill To:   (Note: Email address is required for credit card transactions)

Name:  
Company:  
Address:  
Suite/Appt:  
City:  
State:                                                         Zip:
Telephone Number:  
Email Address REQUIRED:  

Fill in Quantity, add Subtotal, select a Shipping method, and calculate Total

Quantity Product Unit Price Total
  DSL-300 $195.95  
  SAGE-300 $149.95  
  UPX-300 $195.95  
  VDI-100 $149.95  
    Subtotal  
    Shipping  
    Total  

    Shipping:  USMAIL= $8.95 UPS GND=$11.95  UPS 2 Day=$22.00 Next Day=$34.00

bs01575_.wmf (6784 bytes)   Fill in Credit Card Information  (Add Card Number Below)

                               

VISA ___  MC ___       Expiration Date: ________________

Cardholders Name: _________________________________       Click to Return Home