wiley x, inc. quality management system · quality management system. wiley x, inc. total....
TRANSCRIPT
Page:
Exp Date CVV
1 1 of 1
Credit Card Billing Address City/State Zip Code
Shipping Address City/State
2016 Web Order Form - USA
Rev. No.:Title:
QUALITY MANAGEMENT SYSTEM
WILEY X, INC.
TOTAL
COMMENTS:
UPS 1 DAY
SUB TOTAL
SALES TAX
Wiley X is required to collect tax in all 50 states. Please include the percentage of tax required by
your State, before submitting order. Any order that does not include tax will be returned to you and
delay processing.
UPS GROUND
UPS 3 DAY
UPS 2 DAY
PRIORITY MAIL
DESCRIPTION SIZE (if applicable) UNIT COST TOTAL
Cardholder Name Card Number
Payment Type:
QUANTITY ITEM #
Signature
Zip Code
Name Phone Number E-mail Address
Visa Mastercard AMEX Discover Money Order/Check
Check here if Shipping address is the same as the Credit Card Billing Address.
$7.50
$9.00
$18.00
$25.00
$55.00