CDAccess.com Order Form

Name: _______________________________________________________

Address: _______________________________________________________

_______________________________________________________

City: _______________________________ State: ____________

Country: _______________________________ Zip Code: ____________

Phone # (Required): _____________________

FAX # (Optional): _______________________

I would like to purchase the following items from CD-ROM Access:

ITEM QUANTITY PRICE

_________________________________________ _________ ________
_________________________________________ _________ ________
_________________________________________ _________ ________
_________________________________________ _________ ________
_________________________________________ _________ ________
_________________________________________ _________ ________
_________________________________________ _________ ________
_________________________________________ _________ ________
_________________________________________ _________ ________
_________________________________________ _________ ________

[add more lines if necessary]

SUB-TOTAL ________

Tax (8.75% for Tennessee Residents only) ________

Shipping (Per Order - SEE BELOW) ________

========================================================================

DOMESTIC ORDERS ONLY (Within the US)

2 Day Delivery FLAT RATE $5.95 within the Continental US.

Alaska/Hawaii/APO/US Territories FLAT RATE $9.95 (By Insured Registered Airmail).

========================================================================

INTERNATIONAL ORDERS ONLY:

Small packages with a total value of $30 or less, FLAT RATE $9.95 (Canada $5.95) by Overseas Airmail. Anything large or with a value over $30 MUST BE SENT by DHL or AIRBORNE. It is usually best to ask for a quote on any large shipment.

Overseas Airmail ___ (Must be SMALL and valued at $30 or less)

International Courier ___ (DHL or Airborne Express) ========================================================================

FINAL TOTAL ________

Payment by (check one): VISA ___ M/C ___ DISC ___ AMEX ___

Card Number (see below): ________________________________

Expiration Date: __________ <---- IMPORTANT!

Note: we only need credit card information on your first order or if the card number or expiration date has changed.

Check ___ M/O ___

All prices are in US Dollars. Please ask before sending any checks or money orders unless it is in US Dollars drawn on a US bank.

Our Mailing Address is:

CDAccess.com
6870 Comstock Road
College Grove, TN 37046

Voice (615) 595-0950, FAX (615) 595-1599, Toll Free (800) 959-5260

Email: sales@cdaccess.com