ORDER FORM FOR STRETCH BREAK PRO ================================================================== COMPLETE THIS FORM AND SEND WITH CHECK OR MONEY ORDER Name:________________________________________ Company:________________________________________ Street Address:________________________________________ ________________________________________ City, State, ZIP: ________________________________________ Phone: ________________________________________ E-mail: ________________________________________ STRETCH BREAK PRO US $44.95 x ____ unit(s) = $__________ California residents add 7.75% sales tax $__________ Shipping & Handling: Continental U.S. $ 4.00 Canada, Mexico $ 6.00 International $ 10.00 2 day USA $ 8.00 Overnight USA $ 16.00 $ _________ TOTAL: $ _________ FOR MAIL OR FAX CREDIT CARD ORDERS Fax them to 714-546-4607 or send this form with the information below. _______________________ | | Name As It Appears | Please make checks | On Credit Card:____________________________ | payable to: | | | Card Number: _______________________________ | Para Technologies | | 3273 Indiana Avenue | VISA[ ] | Costa Mesa, CA 92626 | MC [ ] | | AmEx[ ] | Voice: 714-546-8619 | DISC[ ] | FAX: 714-546-4607 | |_______________________| Expiration Date ___/___ Signature: _________________________________ You can also place credit card orders by sending the above information by e-mail to paratech@earthlink.net or call in your credit card order to 714-546-8619 between 9am and 7pm Pacific Coast Time.