Advantage USA: Order Form

Print Order Form
Must be used for
International Orders
Which Require Signature
For Credit Card

We also have a secure online order form and a regular order form.

Circle your payment method:
Credit Card (see below)
Personal check enclosed
Official bank check enclosed
Money order enclosed

Send or fax this form to

Advantage-USA
1820 Summit Dr. NE
Rochester MN, 55906
Tel: 800-779-2136
Fax: 507-536-9450

Terms

Payment in full is required upon receipt of merchandise.
We accept personal checks, money orders, bank checks, and now credit cards.

Please feel free to call us.

**Your Information**
____________________________________________ Legal Name of Individual or Business Authorizing Charge

____________________________________________ Address

____________________ City	__________________________ State/Province, Zip/Postal Code, Country

____________________ Phone	_____________________ Fax

____________________________________________ Email

The following individuals are authorized to order merchandise from Advantage USA using this credit card as payment:
____________________________________________

Type of Credit Card
Visa______________________________ (Enter Credit Card Number)	_____________________ Exp. Date

MasterCard________________________________ (Enter Credit Card Number)	_____________________ Exp. Date

____________________________________________ Name as if Appears Exactly on Card

____________________ City	__________________________ State/Province, Zip/Postal Code, Country

The undersigned herby declares that the credit information listed above is true, accurate and appears in the name of the stated and authorization is hereby given to the above named individuals to use this credit card for purchases from Advantage USA. Further, I authorize my credit card company to accept and to charge to my account purchases initiated by the above named individuals from Advantage USA. I also acknowledge that if such purchases are to be rec-occuring that this authorization allows Advantage USA to continue to use this information and such information shall remain in full force and effect until I revoke such authorization ion writing.

____________________________________________ Signatue of Cardholder

**Your Order**
Stock Number	Quantity	Price	Total
	*	$=	$
	*	$=	$
	*	$=	$
	*	$=	$
	*	$=	$
	*	$=	$
	*	$=	$
	*	$=	$
	*	$=	$
Order Subtotal

**Shipping & Handling Charges**
Up to $50	Add $3.00*
Up to $100	Add $4.00*
Up to $150	Add $5.00*
$150 and Over	Add $6.00*
Shipping & Handling Subtotal:

(*) These charges apply to shipping and handling in the US.
Please contact us for cost of shipping to other countries.

Payment

Total payment, in US dollars:

Please make your check or money order in US funds to "Advantage USA".

Terms:

Payment in full is required upon receipt of merchandise. We may request payment in advance for new customers, or ship COD under certain circumstances.

Any other important information:

Also we now have: