Micro-Transmission Line System - Order Form
Warren Gregoire and Associates







For your security web orders are not available, yet.
However, you may call us toll-free, 1-800-634-0094
(USA and Canada) to place your order.
For all other countries, call 510-282-9300.
You may print the following order form and fax it to 510-597-0421,
or mail it to our office at 3400 Mt Diablo Blvd, Suite 202 Lafayette CA 94549, USA.




ITEM QUANTITY PRICE EACH TOTAL
       
       
       
       
       
SUB TOTAL
CALIFORNIA RESIDENTS ADD 8.25% SALES TAX
SHIPPING & HANDLING (SEE BELOW)
ENCLOSE CREDIT CARD CHARGE, CHECK/MONEY ORDER FOR TOTAL
MICRO TRANSMISSION LINE SYSTEM QUANTITY DISCOUNT
AND SHIPPING AND HANDLING CHART
QUANTITY

1
2 - 3
4 - 7
8 - 15
16+
WHILE SUPPLIES LAST
UNIT PRICE

$19.95*
$14.95*
$10.95*
$ 7.95*
$ 6.95*
PER UNIT
UNITED STATES

$ 6.50
$ 8.50
$10.50
$14.50
$21.50
GROUND SERVICE
CREDIT CARD ORDER INFORMATION

________ VISA ________ MASTERCARD ________AMEX ________ DISCOVER

________________________________________________________________________
CREDIT CARD NUMBER AND EXPIRATION DATE

________________________________________________________________________
CARDHOLDER'S SIGNATURE

SHIP TO INFORMATION

NAME ________________________________________________________________

ADDRESS _____________________________________________________________

______________________________________________________________________

______________________________________________________________________

APARTMENT/SUITE NUMBER ______________________________________________

CITY _________________________________________________________________

STATE/PROVINCE _______________________________________________________

ZIP/POSTAL CODE ______________________________________________________

COUNTRY _____________________________________________________________

DAYTIME TELEPHONE NUMBER (REQUIRED)

( __________ ) _________________________________________________________


QUESTIONS? NOW CALL TOLL-FREE 1-800-634-0094

   

Specifications, prices and availability subject to change without notice.
Copyright 2005 Warren Gregoire and Associates LLC
All Rights Reserved

 



WGA