Computer-furniture.com
256 East Jericho Tpke, Mineola,NY 11501
1-516-967-5560  Mon-Fri 8:00 am - 5pm EST
Fax: 516-248-5966
E-mail: cyrus@computer-furniture.com

We accept company check, bank check, money order, or major credit card and purchase order with this order form.

 

DATE:

ORDERED BY: (Please Print)
Customer Name

SHIP TO (if different than purchaser)
Name

Address

Address

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City____________________St___ ___Zip

City________________St_____Zip

Phone # ________________________Fax #

Recipient Phone #

Daytime Phone #

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E-mail Address

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_ ITEM #

_ QTY

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_ ITEM DESCRIPTION

_COLOR

_ UNIT PRICE

TOTAL

 

 

 

 

 

 

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PAYMENT METHOD: (Circle One)

AMEX _____ VISA _____ MASTERCARD _____ DISCOVER

MERCHANDISE
TOTAL

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$

CREDIT CARD #:

SHIPPING CHARGE

_

EXPIRATION DATE: (MM/YY)

$0.00

NAME ON CARD:

SUBTOTAL                                  $

SIGNATURE:

 

 

SALES TAX                                  $0.00

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TOTAL

$

H.T.C Inc. ships within the Continental United States.  For all orders shipping to Alaska, Hawaii, APO,FPO and International destinations, special shipping costs apply.
     **Orders to ship within 2 business days       ** Allow 10 business days for delivery.