WEB ORDER FORM -------------- Silk Label Books * Order Dept * First Avenue PO Box 399 * Unionville * New York 10988-0399 (845) 726-4444 * FAX: (845) 726-3824 email: mail@rfwp.com Bill To: Name_______________________________________________________ Street Address_____________________________________________ City_________________________State__________Zip____________ Date_________________Purchase Order # _____________________ Visa/Mastercard # _________________________________________ Expiration Date____________________________________________ Authorized Signature_______________________________________ Only institutional purchase orders will be accepted. Individuals must include payment with order. Please be sure to include shipping with payment. Foreign orders should be prepaid in U.S. currency. Checks should be made payable to "Silk Label Books" and sent to the above address. Order # Quantity Title Price each Total ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Order Total $_________ Shipping & Insurance $_________ (orders up to $40.00, add $4.00; orders of more than $40.00 add 10%. non-USA orders will be billed for shipping at cost for best available delivery method. Sales Tax 7.5% (N.Y. Residents only) $_________ Total Amount Enclosed $_________ Ship To: Name________________________________________________________ Street Address______________________________________________ City___________________________State__________Zip___________