CornerIts FAX Order Form

Print-And-FAX Ordering

OK, so you don't feel comfortable emailing your credit card information over the Internet... Simply print this form and fill it out the old fashion way and FAX it to us at: 303-355-6323

The CornerIts will be shipped upon receipt of valid credit card information, check, or money order.

Name   :_____________________________________

Company:_____________________________________

Address:_____________________________________

City   :____________________________ State: _ _ Zip Code :_ _ _ _ _  _ _ _ _                  

Country:__________  Telephone:    (   )     -            Fax : (   )    -

E-Mail Address (optional): ____________________________

Circle Form of Payment: MasterCard, Visa, Check
 
Name as it appears on Card:__________________________  

Credit Card Number: _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _  Exp.Date: _ _ / _ _

The Economy 3 Pack comes with 3 complete sets of CornerIts! Each set has 
4 individual CornerIts.

Please select a color choice.

Item #103-3       | Quantity | Price   | Total
---------------------------------------------------------------------
Clear CornerIts   :          | $ 7.50  |
Black CornerIts   :          | $ 7.50  |
White CornerIts   :          | $ 7.50  |
Assorted CornerIts:          | $ 7.50  |

Colorado Residents add    Sales Tax :   ___________________

                      Shipping 1.50 :   ___________________

                       Total Amount :   ___________________

Oldowan Company
1633 York Street
Denver, CO  80206

FAX  : 303-3556323
Voice: 800-847-8308 or 303-355-2479 


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