ORDER FORM
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Order Via PayPal® It's Safe & Secure! |
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| Note: You do not need to have a PayPal® account to purchase this item. A shipping fee of $4.50 has been added to the sales price, please contact us if you would like faster shipping than standard USPS. | |||||
| TO ORDER VIA US MAIL OR FAX: 1. Complete this form in its entirety, print it (keep a copy!). 2. Mail this form and your check order. |
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PURCHASER INFORMATION |
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| Name: | |||||
| Company: | |||||
| Email: | |||||
| Phone: | Fax: | ||||
| Address 1: | |||||
| Address 2: | |||||
| City: | |||||
| State/Prov: | |||||
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PRODUCT PRICING |
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| Item Mail Order Software |
Qty |
$ ea. |
$ Total |
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Sub-Total: |
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| Select Shipping
& Handling: $4.50 Standard USPS (U.S. Mail) |
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TOTAL ENCLOSED (including S&H) $ |
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MAIL / FAX YOUR ORDER TO: |
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Larck Services, Inc. Questions? Use our Contact Us page, click here. |
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