Sociometrics Corporation
170 State Street, Suite 260
Los Altos, CA 94022-2812
Return to Home Page
Fax: 650-949-3299
Phone: 650-949-3282
E-Mail: socio@socio.com

SAMPLE Sociometrics Order Form

To Order:
or:
or:
  • print and complete this form & fax it to 650-949-3299,
  • print and complete this form & mail it to Sociometrics (address above),
  • Call Sociometrics' Phone Order Hotline at 800-846-3475.
BILL TO
Name: Sue Doe-Nim
Organization: University of Atlantis
Department: Contemporary Anacronisms
Street Address: 1 Ironic Pl.
City, State, Zip: Tempest, CA 77777
Phone (w/ ac): (555) 123-4567
Fax (w/ ac): (555) 123-4444
E-mail: 14damoney@atlantis.pun

SHIP TO (only if different from above)
Name: Al Formee
Organization: University of Atlantis
Department: Contemporary Anacronisms
Street Address: 1 Ironic Pl.
City, State, Zip: Tempest, CA 77777
Phone (w/ ac): (555) 765-4321
Fax (w/ ac): (555) 765-4444
E-mail: 24daroad@atlantis.pun

PRODUCT CODE
(from catalog)		 PRODUCT DESCRIPTION UNIT PRICE
DAPK1-K2CD NSAM 1991 on CD-ROM $225.
EVALPUBL9 Planning an Evaluation (pub) $3.
. . .
. . .
TOTAL: $228.

Use the space below for any notes, comments, or special requests regarding this order.


Payment Type (check one):
_X_ credit card
___ purchase order
___ check/ money order.