I E Net

FAX/MAIL ORDER FORM

Print out and complete this form and mail or fax it to us.
Qty. Product Name and/or Title Part # Price TOTAL



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Add shipping:(Leave blank if unsure)

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Total

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Circle payment type:

Billing information: Shipping information:
Cardholder Name__________________________________
Company Name___________________________________
Credit Card Number________________________________

Expiration Date:_________________________

Signature________________________________
Cardholder Address________________________________________

City________________________

State________________ Zip Code_________________

Country______________ Phone:(____)_____________

Bank Name_________________________________

Ordering Instructions

Mail or Fax this form to:
I E Net
8336 Bella Vista
Alta Loma, Ca. 91701-1332
Fax: 909-987-7907.

To Order by Check: Make checks payable to I E Network Please allow 14 days for processing.

Shipping Policies

Please allow 2 business days for order processing.


Copyright ©1997 by I E Net. All Rights Reserved.