Order Form

 stayconnL2a.gif (43051 bytes)    $ 9.95  
(Arizona Residents add $.72 sales tax)

 Your Name:  
 Company:  
 Address:
(Must Match credit card Billing address)
 
 City  
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 Zip Code:  
 Email Address:
(conformation will be emailed back)
 
 Web Address:
(Http://www.Your site.com)
 
 Phone Number:
 
 Fax Number:
 
System ID:

 

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 SELECT PRODUCT(S)

 

       $9.95 Activation Code
               for Stay-Conn

 

 


Credit Card Orders

Payment Information:

Credit Card:

Credit Card Number:

Expiration Date:

The Charge Will appear on your Credit card Statement as
Steve Karas and Associates


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Fax Order
To order by fax Print this order form and fax it to 602-494-9134


Mail Order
Print this order form and Mail it along with your check to
Steve Karas and Associates, 3341 E Turquoise, Phoenix, Az.  85028


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Copyright 1997 Steve Karas. All rights reserved.
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