Order Form - fields out

EASY FAX FORM
Perfect
Partner
Code:
Standard Product
96881
Fax: 1-888-577-6891 Call: 1-800-465-2888 www.nebs.ca
1. Bill To
Please fill in your company name, street address, city/town,
province, postal code and telephone number below.
Please fill in your Catalogue Code
2.
(Located in box on back cover of catalogue)
Company Name
N/A
Telephone Number
Contact Person
1. Complete page 1 by typing directly into form.
2. Print page 1 and fax to NEBS at 1-800-461-3325.
3. Refer to pg 2 and 3 below for further information.
Address
City/Town
Province
Postal Code
Yes
Yes
Do we have permission to market to you by E-mail?
Do our business partners have your permission to market to you by E-mail?
No
No
E-mail address
3. Ship To
Fill in only if different from "Bill To" information.
Air Miles
®
Collector Number
Company Name
Please indicate below which type of Accounting Software you use.
Attention/Contact Name
Area Code Telephone Number
Street Address (Include P.O. Box and/or Floor Room or Suite Numbers)
Area Code Telephone Number
City/Town
4.
Province
Product Information
Quantity
Product # / Description
(See pg 2 & 3 for details)
✔
What type of printer do you use?
Postal Code
Laser
Inkjet / Bubblejet
Cheque Colour
Typestyle Number
Nebs Logo Number
(See pg 2 for details)
(See pg 3 for details)
Dot Matrix
Select options for each product as specified in catalogue.
Starting Cheque #
(If not specified,
numbering starts at 1001)
9206, 1 part, Laser 11" cheque
-
Easybooks Online
Amount $
(See pg 3 for details)
(See pg 3 for details)
3
-
-
-
-
ADD YOUR OWN LOGO
Additional Cheque Order Information
We will reproduce your existing logo
at a flat rate of $35/logo.
For 1st time cheque orders, please forward a sample cheque marked "VOID" or a completed MICR specification
sheet from your bank. This will detail bank routing numbers and imprint information to ensure accurate MICR encoding.
0.00
SUBTOTAL
Then FAX or MAIL to NEBS. When faxing please enlarge the sample - thanks!
To reorder your cheques, simply advise your NEBS Consultant of your previous order(s).
5.
Imprint Information
Your printed sample or accurate wording provided
below is all that's needed!
NUMBER OF SIGNATURE LINES REQUIRED ON CHEQUE FORM:
One
Two
-
8%
0.00
GST/HST
-
6%
0.00
SHIPPING /HANDLING FEE
will be added to your order. This is calculated
based on value of products and your location.
Imprint instructions for Product Number(s)
Line 1:
Line 2:
TOTAL
Line 3:
Line 4:
Thank you for your Order!
Line 5:
(Note: If more space is required, continue on another sheet and include your name and telephone number).
6.
PST
Payment Information
Bill Me
Payment Method:
Cheque Enclosed
American Express®
Signature:
Business or Personal Name on Card:
(please print)
Card Expires:
Card Number:
mm/yy
Your order, plus shipping fee and applicable provincial and federal sales taxes, will be billed directly to your credit card
MasterCard®
VISA®
$0.00
EASYBOOKS CHEQUES & MATCHING ENVELOPES
#9206, Laser 11” Cheque
1 . P le a s e ch oos e a T y pe s ty le for y ou r com pa n y n a m e a n d e n te r on for m
2 . I f y ou w is h to pr in t a F r e e N e bs L og o on y ou r for m g o to w w w . n e bs . c a , s e le ct “ P r odu cts ” a n d
t h e n c l i c k o n ‘ V i e w L o g o s ” . E n t e r t h e lo g o n u m b e r o n y o u r o r d e r f o r m .
3 . P r i c i n g I n f o r m a t io n :
Q u a n tity
9 2 0 6 1 - copy L a s e r 1 1 ” C h e q u e
Q u a n tity
9 2 0 6 2 - copy L a s e r 1 1 ” C h e q u e
Q u a n tity
9 2 0 6 3 - copy L a s e r 1 1 ” C h e q u e
150
200
250
500
1000
$94.95
$103.00
$111.00
$140.00
$206.00
150
200
250
500
1000
$130.00
$150.00
$170.00
$214.00
$365.00
150
200
250
500
1000
$177.00
$192.00
$206.00
$280.00
$487.00