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^{World
of Fax & Copiers Order Form}

World of Fax and Copiers supplies dealers and end users with Fax, Copier & Printer Parts since 1989. Feel confident in placing your order with a proven leader in the industry. Please provide the following contact information and click the "SUBMIT" button below:

You may print and FAX Orders to 845-624-2299

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^{We Accept}

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Please provide the following contact information:

Name

Title

Organization

Work Phone

Home Phone

FAX

E-mail

SHIPPING ADDRESS

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

BILLING

Credit Card

Cardholder Name

Card Number

Expiration Date

URL

	^{SHIPPING PREFERENCE}

Please provide the following product information:

Product Name

Model

Please provide the following ordering information:

QTY DESCRIPTION ^PRICE

Name
Title
Organization
Work Phone
Home Phone
FAX
E-mail
	SHIPPING ADDRESS
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
	BILLING
Credit Card
Cardholder Name
Card Number
Expiration Date
URL

Author information goes here.Copyright © 1999 [OrganizationName]. All rights reserved. Revised: March 08, 2007

Author information goes here.
Copyright © 1999 [OrganizationName]. All rights reserved.
Revised: March 08, 2007