| MSC
Electronics P.O. BOX 461 Jessup, MD 20794 |
Phone (301) 497-1600 |
Print this Form
and Fax or Mail to :
Ship to: ____ Residence ____Business (Name must be as it appears on the credit card)
Name______________________________________Date___________________________
Address____________________________________Email Address___________________
City____________________________State________Zip Code_______________________
Phone(_____)________________Phone(Evening)__________________Fax_____________
| Quantity | Item Number | Description | Unit Price | Amount |
| Sub Total | |
| Shipping | $12 |
| *Additional Shipping | |
| MD residents add 6% sales tax | |
| TOTAL |
For more items use the Additional Form
*Additional shipping may be required for orders over 10lbs.
Credit Card Orders: VISA or MASTER CARD
$10.00 Minimum on Credit Cards.
ALL credit card orders MUST be signed.
NO
PERSONAL CHECKS
Card NO.________________________________
Exp. Date_____/_____Credit card Billing address_________________________________
__________________________________________________________________
Signature(required for credit cards)______________________________________
Terms:(Unless Specified elsewhere) NO CODs. Credit card orders can not be shipped to Post Office boxes. NO Foreign Orders. Orders over 10 lbs. may be subject to additional shipping. Prices are subject to change without notice. All Items are subject to prior sale. Maryland residents add 6% state sales tax |