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5.7.9.6.3 Irie Pascal (Universal Edition) UK Order Form

No. UsersUnit PriceQuantityTotal Price
    1    74.99________ _____________
    5    65.99________ _____________
   10    56.99________ _____________
   20    47.99________ _____________
   40    38.99________ _____________
  100    29.99________ _____________
Shipping
& Handling     3.00 _____________
TOTAL _____________

[  ] Check/Money Order enclosed

Name:_______________________________________________________

Address:____________________________________________________

City/State/Province:________________________________________

Country/Postal Code:________________________________________

Telephone:_______________________________________ [optional]

Email Address:___________________________________ [optional]

How did you hear about Irie Pascal?_________________________

_________________________________________________ [optional]

[  ] Tick this box to join the Irie Pascal mailing list.

Please do not send cash. Make checks or money orders payable to Irie Tools. All prices are quoted in UKŁ and are guaranteed until December 31, 2005. Please allow two to four weeks for delivery. If you fill in your email address you will be notified by email when your order is shipped.

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