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ASCII Computer Center
2840 Stirling Road, Suite I
Hollywood, FL 33020

Daytime Phone (important)_________________
Email address ___________________

ORDER LINE: (954) 925-1313
Fax: (954) 925-2443
M-F 10 am - 3 pm EST
Credit Card Billing Address:
Name________________________________
Address___________________________
City________________________________
State______Zip___________ 		Ship To:
Name________________________________
Address___________________________
City________________________________
State______Zip___________
Quan. Item # Item Description Price/ea Line Total




























































Method of Payment:
__ Money Order or Check
__ Credit Card (MasterCard, Visa)

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Expiration Date _______________________
Authorization Signature (required to be valid)
________________________________________

Sub Total: ________

S/H (US=$15/Int'l=$67): ________
Air (US=$15 or $25): _________
6% (FL): ________

Total: ________

2nd and NEXT DAY AIR: This is REQUIRED for US hotel orders. Price is based upon weight. Actual 2nd day air charge added to basic shipping and handling charge.


IMPORTANT: We require a photocopy of your credit card (front and back) and a valid Passport or Driver's License as part of our fraud protection.

C.O.D.: Sorry, we do not ship any orders COD.

SALES TAX: You must include 6% sales tax if your order is to be sent to an address in Florida. Call us for California tax rates.