Easy Publisher 2000 Order Form

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Easy Publisher 2000 Order Form

Be sure to copy the correct item description, title, and price to fill in and print this form out. If you do not have a printer just include in a note the item description, the title, your shipping address, appropriate shipping and handling charge, plus price for each item you are ordering with a check or money order made out to: Lester Kelly and mail to the address on this form.


TO ORDER


	Complete, print, and then fill in appropriate sections.

Purchaser Information:

Name:

Company:

Email:

Phone:

Fax:

Address:

City:

State/Prov:

Zip/Postal:

Country:

Send Your Order To:

Lester Kelly
4314 SouthPark
Tyler, Texas 75703
903-581-5404
kellyres@37.com

Payment Options

By Check or Money Order

Note: all orders are process and shipped the some day we recive your order. All fields must be completed. Fraudulent use of BANK information is strictly prohibited by State and Federal Laws. ALL transactions are logged and any fraudulent activity reported. If time is important to you, use your Credit Card to Order since this process is quicker.Enter all the numbers on the bottom of your check (use spaces for odd characters):
_________________________________________________
Name on check:__________________________________________
Address on check:________________________________________
City:____________________ State:__________ Zip:___________
Day/Night Phone #'s:___________________ /__________________
What is the FULL check number:_____________________________
Total Check Amount This Order: $____________________________


Your Bank Check Information

Name of Bank:____________________________________________

Bank Branch Name or Number:______________________________

City:____________________  State:__________  Zip:____________

Phone# of Bank (if not on check)_____________________________

Enter 9 digit routing #:__________________________ (see diagram)

Bank account#:_________________________ Date:____/____/____

1. All fields must be filled in. If they are not, orders may not be processed.
2. ALL BAD CHECKS WILL BE CHARGED A $25.00 FEE. NO EXCEPTIONS !

Make Product Selection:

# Description Qty $ Each $ Totals

1.

2.

3.

4.

5.

Sub-Total:

Select Shipping & Handling:
$5 USA $10 Canada $24 Outside USA

TOTAL ENCLOSED (including S&H) $