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Friction / Brake
Search |
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: |
. |
| Address: |
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| City: |
State: |
| Country: |
Postcode: |
| Tel#: |
Fax: |
| Email: |
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| Web Site: |
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| _____ |
Annual Rate
- US$ 695
Now only
US$ 495 |
| . |
Terms of advertising will be
for Twelve (12) Months from starting date indicated below |
| . |
Starting Date:
__________________ |
| . |
Please email description
of your Company
and Products, |
| . |
preferably in
Microsoft® Word format, to editor@ifriction.com. |
| Payment
Details |
| _____ |
Purchase order (please
attach official company purchase order) |
| _____ |
Check enclosed (issued to 'Gedoran America
Limited' in US$,
drawn on US branch) |
| _____ |
Bill my Credit Card: American Express / MasterCard / VISA
(please circle) |
| Acct#: |
___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ |
| Expiration Date: ___ ___ / ___
___ |
| Name on Card:
__________________________________________________ |
| Signature:
_________________________________________ |
|
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| Fax
form to: +1 (540) 723-6628, or mail, with payment to: |
| Gedoran
America Limited |
| P.O. Box 3431 |
| Winchester,
Virginia 22604 |
| Tel#:
+1 540.723.6628 email: editor@ifriction.com |
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* each company is limited to five product
connections.
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| ** subscription is
subject for review |
| *** prices subject
to change without notice |
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