#### ##### Output 871 Industrial Rd. # # Enablers Suite K # ##### San Carlos, CA 94070 # # Makers of #### ##### The RocketSocket sales@outputenablers.com _______________________________________________________________________ Ordering Information and Order Form Last updated 7/17/12 Please refer to our Product Information sheet and FAQ when filling out this form. This form looks best if printed in a fixed-width font. For orders under $200, we accept MasterCard, Visa, personal checks, and money orders. For orders over $200, we accept only MasterCard, Visa, cashier's checks and money orders (i.e. no personal checks). We do not accept university or government purchase orders. To order from us, fill out this form, and send it to us at the address above. If you are paying by check, please make your check payable to "Output Enablers". Your order will be shipped within two working days of receipt your completed order form. _______________________________________________________________________ Your Name _____________________________________________________________ Your Shipping Address _________________________________________________ _________________________________________________ _________________________________________________ _________________________________________________ Your daytime phone number: ____________________________________________ Your evening phone number: ____________________________________________ Your fax number: _________________________________________________ Your e-mail Address: _________________________________________________ What model Macintosh do you have? Centris ____ Quadra ____ PowerMac____ ____________________________________________________________________________ Please list the products you are ordering: Product Macintosh model Quantity Price Total Price __________________________________________________________________________ | | | | | | | | | | | | -------------------------------------------------------------------------- | | | | | | | | | | | | -------------------------------------------------------------------------- | | | | | | | | | | | | -------------------------------------------------------------------------- Subtotal: | | ----------- If the order is shipping to a | | California address, add 8.25% sales tax: | | ----------- Shipping: | $5.15 | ----------- Total: | | ----------- ____________________________________________________________________________ Payment Information: [] Personal Check Card Number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ [] Money Order [] Visa Expiration Date (mm/yy): _ _ / _ _ [] MasterCard Number above your name (MasterCard only): _ _ _ _ Please print your name and address exacly as it appears on your credit card statement: _________________________________________ _________________________________________ _________________________________________ _________________________________________ Bank that issued card: _________________________________________ Card Holder's signature: ________________________________________ ____________________________________________________________________________