Mini-500 Manual Order Form

MINI-500 ORDER FORM (TEXT VERSION — Please print & use when MAILING your order)

Order By Mail: Print out this order form, and send it along with US FUNDS check or Money Order, or credit card information to:

Vortech, Inc.
PO Box 511-W
Fallston, MD 21047

Order By Phone (3pm to 7:00pm EST): Have your credit card on hand and call:

410-668-2757

Your e-mail address: ________________________________________________

Your Name: ______________________________________________________

Address:_________________________________________________________

City: ____________________________________________________________

State / Province: ______________ Zip / Postal Code: ______________________

Country (if not USA) _______________________________________________

Phone: _______________________________ Fax:____________________________

Please send me (prices include postage):

___ Mini-500 Manuals @ $88 U.S., $109 foreign: $______________

SUB-TOTAL $_____________

SALES TAX (Maryland residents add 6%)_____________

All remittances must be in US FUNDS

TOTAL $ _____________

CREDIT CARD INFORMATION

(We accept VISA, MASTERCARD, AMERICAN EXPRESS & DISCOVER)

CARD TYPE (check one) ___VISA ___MASTERCARD ___AMEX ___DISCOVER

CARD NUMBER: ______________________________________________________

EXPIRATION DATE: (in the form mm/yy; such as, 08/27): ____________________ 3-DIGIT SECURITY CODE (CVV): ___________

NAME APPEARING ON CARD: _________________________________________