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Ergonomics
Training Co. P.O. Box 213 Covington, OH 45318 Phone: (937) 332-1340 Fax: (937) 335-2814 |
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| Item # | Qty. | Cost | Total cost | Item # | Qty. | Cost | Total cost | |
| Column 1 subtotal _____________ | Column 2 Subtotal ____________ | |||||||
| Subtotal (Columns 1 & 2) __________ | Subtotal after discount __________ |
| Less coupon discount __________ | Sales tax 7% (Ohio only) __________ |
| Less volume discount __________ | Shipping & Handling $4.95 |
| Subtotal after discount __________ | Total Cost __________ |
| Payment Options |
Allow 5-7days |
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| ____ Check or money order enclosed, payable to "Ergonomics Training Co." | |||
| ____ Charge to VISA______ MC______ AMEX ______ | |||
| Credit
card#___________________________________ Exp. date: ______ |
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| ____ Bill my company Purchase Order # __________________________ | Terms: Net 10 Days | ||
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Signature __________________ |
Phone#:______________________ |
Date: _____ |
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| Ship to: (Please print) | Bill to: |
| Name: ________________________________ |
ACCOUNTS PAYABLE |
| Company: _____________________________ | Company: ______________________________ |
| Address: ______________________________ | Address: _______________________________ |
| City, State, Zip: __________________________ | City, State, Zip: __________________________ |