GetWebPics (product number 4479-10): order form
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Mail this form to: Universal Commerce, Inc.
ATTN: Orders
PO Box 1816
Issaquah, WA 98029
United States of America
Or fax it to: 1 888 353-7276 (U.S. and Canada; toll-free)
1 425 392-0223 (other countries; regular)
Or just call: 1 877 353-7297 (U.S. and Canada; toll-free)
1 425 392-2294 (other countries; regular)
Check, money order, purchase order or credit card order accepted
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Note: for mailed orders, the checks need to be made out to Universal
Commerce Inc. The product ID (4479-10) should be mentioned on the
"memo" of the check. Checks and money orders should be drawn in US
Funds. A purchase order must be faxed or mailed to the address listed
above with all necessary information including billing information.
Order Information
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GetWebPics (4479-10) Price/Unit Quantity Total
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Personal license ____ ____ ______
Mail or fax order $2.50 ______
TOTAL AMOUNT ($U.S.) __________
Note: if you place an order by fax (with credit card), or pay with
check, money order or purchase order, please include additional
$2.50 (see above). Otherwise, your order will not be processed. If you
place an order by phone, you'll be charged for additional $3. For
online orders, there are no additional charges.
Payment Information
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First Name: _____________________________________________________
Last Name: _____________________________________________________
Company: _____________________________________________________
Street Address: _____________________________________________________
_____________________________________________________
City: _____________________________________________________
State/Province: _____________________________________________________
Zip/Postal Code: _____________________________________________________
Country: _____________________________________________________
Daytime Phone: _____________________________________________________
Fax: _____________________________________________________
Email Address: _____________________________________________________
Payment: __ MasterCard __ VISA __ AMEX __ Discover
__ Check __ Money order __ Purchase order
For credit card orders:
Name on Card: ________________________________________________________
Credit Card Number: __________________________________________________
Expiration Date: month _______________ year (4 digits) _______________
Signature : ____________________ Date: ______________