JFB Desktop Publishing

112 Eucalyptus Ave., South San Francisco, CA 94080

Fax: (650) 872-2774 Or (800) 794 -8345

Diploma Shop Order Form

Fill out this order form and print it. Mail or fax it to me . Keep a copy for your records.
We do not trust the web with credit cards. There is always the possibility a talented hacker can compromise you.

. Information on electronic funds transfers to pay for purchases

Name:

Address:

Ship to Above Address

Ship to Below Address

Ship To:

Payment Options:	Mail with Cashier's Check
	Mail with Personal Check (wait for check to clear)
	Pay by Credit Card

Credit Card:	Visa
	MasterCard
	American Express
	Discover

Card number : Expiration : Security code from back of card

Name on Credit Card:

Card Billing Address:

Home Phone with Area Code :

Day Phone with Area Code : Fax Number:

E-mail :

DESCRIPTION		PRICE	QTY	TOTAL
				$
				$
				$
				$
				$
				$
				$

		Sub Total	$
	Ca Residents add sales tax	Sales Tax	$
U.S .Shipping Groundtrack in Continental US ($7.50 / item up to a total of $30.00) Groundtrack shipping on Bulk Pack cases of Certificates- $25.00 International $25.00 and up Depending on weight and destination			$
		TOTAL	$

We thank you for your support.

Signature:_______________________________