2717 Carol Road - Union, NJ 07083 USA
URL: www.strokemaster.com Email: sales@strokemaster.com
Please print this form for use with Fax and Postal Mail orders.
Shipping Information
Name ________________________________________________
Address ________________________________________________
City ___________ State/Prov. ______________________
Zip Code ____________ Country _______________________
E-Mail Address____________________ Phone ___________________
Product Information
Quantity Product name Price Total
______________|_Starter Kit________|___$10.95_____|___________
______________|_Replac. Cards(25)__|___$ 5.00 ____|___________
S/H per Item (Kit=$4.00)(Repl.Cards=$2.00)__|___________
S/H per Item (Outside Cont. USA=$15.00)_____|___________
ORDER TOTAL: US$___________
Payment Information
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