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BaskWare -
Order Fax Form
To order via fax,
use browser PRINT BUTTON to print this form, fill it out, and fax it to (248)
692-0342
Note: We
will e-mail you to confirm your order.
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me the following products (print out multiple sheets if necessary): |
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Product
Name
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Description |
Comments
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Price
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MI Residents Add 6% Sales Tax
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Shipping |
FREE |
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Total |
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| Contact
Information: |
| Name
(as shown on credit card): |
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| E-Mail
Address: |
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| Billing
Information: |
| First
Name: |
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Last
Name: |
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| Address: |
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| City,
State (or Province), Zip: |
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| Country: |
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___ Check here to ship to Billing Address above or fill out the
following:
| Shipping
Information: |
| First
Name: |
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Last
Name: |
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| Address: |
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| City,
State (or Province), Zip: |
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| Country: |
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Payment Method:
__ VISA __ MasterCard
__ American Express
| Credit
Card # and Expiration Date: |
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