Printable JMI
Order
Form
Print this form and phone, fax or mail your order (or copy and paste it to an email message formatted for HTML).
| Bill To | Ship To | ||||
| Name: | Name: | ||||
| Address: | Address: | ||||
| Address: | Address: | ||||
| City: | State: | ZIP: | City: | State: | ZIP: |
| Country: | ❑ Bus. ❑ Res. | Country: | ❑ Bus. ❑ Res. | ||
| Phone: | Type*: | Phone: | Type*: | ||
| Alternate: | Type*: | Alternate: | Type*: | ||
* Work, Home, Mobile, Pager, Fax, Email
| Method of Payment | Telescope Information | |
| ❑ Check ❑ Money Order ❑ C.O.D. ❑ VISA ❑ MasterCard | Telescope Make and Model: | |
| Card Number: | Exp. Date: | Mount Make and Model: |
| Signature: | Year Manufactured: | |
| Part Number |
Product Description |
Order Quantity |
Price Each |
Total Price |
Shipping
& Handling |
| Today's Date: | Merchandise Total ($30 minimum) | XXXXXXXXXX | |||
| Comments: | Sales Tax (see tax info) | XXXXXXXXXX | |||
| Shipping and Handling | XXXXXXXXXX | ||||
| C.O.D. Charge (if applicable) | XXXXXXXXXX | ||||
| Grand Total | |||||
JMI
Telescopes · Jim's Mobile, Inc. · 1960
Kerr Gulch Rd · Evergreen,
CO 80439 · U.S.A. |