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| Facts
About Friction |
Regular
Order Form |
PLEASE
PRINT THIS FORM AND FAX TO: +1 540 723 6628
| Company
Details |
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| Name: |
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| Position: |
Department: |
| Company: |
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| Address: |
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| City: |
State: |
| Country: |
Postcode: |
| Tel#: |
Fax: |
| Email: |
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| Order
Details |
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| _____ Copies of 'Facts
about Friction' @ $149.95 each |
__________ |
| _____ International*
orders add $100.00 for shipping each copy (option: you can provide own
shipping arrangements) |
__________ |
|
Virginia USA residents only,
add 5.0% sales tax |
__________ |
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TOTAL US$ |
__________ |
| * Outside
United States and Canada |
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International Customers are responsible for any importation duties |
| Gedoran
America does not accept wire transfers as payment or payment on
delivery |
| Payment
Details |
| _____ Check enclosed (US$,
drawn on US branch) |
| _____ Bill my Credit Card: American
Express / MasterCard / VISA (please circle) |
| Acct#: ___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ |
| Expiration Date: ___ ___ / ___
___ |
| Name on Card:
__________________________________________________ |
| Signature:
______________________________________________________ |
| . |
| Or
return this form, with payment to: |
| Gedoran
America Limited |
| P.O. Box 3431 |
| Winchester,
Virginia 22604 |
| Tel/Fax #:
+1 540.723.6628 |
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