McCarron-Dial Systems, Inc. P.O. Box 35285 Dallas, TX 75235-0285

Telephone: 214/634-2863 Fax: 214/634-9970

ORDER FORM

Date: _________________________ P.O. Number: ___________

 BILL TO:  SHIP TO: (if different from billing)
  Name of Organization   Name of Organization
   
 Attention  Attention
   
 Billing Address  Shipping Address
   
 City - State - Zip  City - State - Zip
   
 Authorized Signature  Telephone:
   Fax:

Is your organization tax exempt? No _____ Yes _____ If yes, please submit tax exemption certificate with order.

Prices are F.O.B. Dallas, TX; shipping/handling added to invoice. Please allow 10% for shipping and handling, minimum charge of $8.95 applies. Orders less than $100.00 shipped to residential addresses will be charged a $5.00 fee in additional to shipping. Rates outside the continental U.S. will be higher, please contact MDS for current rates. All prices are listed in U.S. Dollars. MDS accepts organizational purchase orders or pre-payment by check.

 Description

Qty.

Each

Total

         
         
         
        
         
        
         
        
        
         
       
       
       
         

For software orders please specify; IBM/PC _____ Macintosh _____

All software is provided on CD-ROM unless otherwise requested.

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