Focus Technology Product Order Form
Fax Order Form to  9 5 2 . 9 3 3 . 0 7 0 0
 

Name: ______________________________________
Email:_______________________________________
Phone No. ___________________________________
Fax No. _____________________________________
 

VISA/MC/AMEX No. ______________________________
Card Security Code ______________________________
Exp. Date ______________________________
Signature ______________________________________

Shipping Address
___________________________________________
___________________________________________
___________________________________________
___________________________________________

Cardholder Name and Billing Address
___________________________________________
___________________________________________
___________________________________________
___________________________________________

Check Box All information provided above is accurate and current.
 

Part Number and Product Description
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________

Quantity
________________
________________
________________
________________
________________
________________
________________
________________

Unit Price
_______________
_______________
_______________
_______________
_______________
_______________
_______________
_______________

Total
________________
________________
________________
________________
________________
________________
________________
________________

 

Domestic Shipping:
Check Box UPS Ground
Check Box UPS 3 Day Select
Check Box UPS Next Day
Check Box FedEx Ground
Check Box FedEx Saver
Check Box FedEx Overnight
Check Box Other:___________________________
Check Box On Your UPS or FedEx Acct: _____________________

 

 

Subtotal: ______________
Tax Rate (MN): 6.875%
Tax:___________________

We will calculate the Shipping
cost and get back to you with
a Total before we charge anything.

International Shipping:
Check Box Ground (Canada)
Check Box Express (Canada)
Check Box Economy
Check Box Priority
Check Box First (2 business days to Europe)
Check Box Other___________________________________
Check Box On your Account:__________________________

 

 

 

 

 

 

 

 

Focus Technology International 1355 Park Road, Chanhassen, MN 55317 USA
1.952.345.5800   |   1.877.959.5800   |   Fax 1.952.933.0700

Products, specifications and prices subject to change without notice. ©2011