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PRINT THIS FORM AND FAX OR MAIL IT TO:
Whitfield Jack Jewelry Genius tm.....200 Elizabeth Street.....Key West, FL 33040
Member: Key West Chamber of Commerce
FAX: 305-296-4745.....PHONE ORDER: 1-800-845-2243 

Qty.
 .

Price each

Total

Compact Disc for Windows and Macintosh

$15.00

  Subtotal

Florida residents add 7.5% sales tax

Postage: one to two discs: $4.00

 Postage: Quantity orders or FedEx, please contact us

Grand Total

FAX THIS FORM OR SEND IT BY U.S.POST OFFICE MAIL
DO NOT SEND CREDIT CARD INFORMATION BY E-MAIL

Name  
E-mail/Phone E-mail: ............................................................. Ph:
Billing
address		  
Shipping
address,
if different		  
Card: ___Visa.....___MasterCard....___Amex  Sec. Code:
Card# & Exp. .  Exp: M/Y
Name on Card  

Type message or special instructions in this box


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