McCarron-Dial Systems, Inc. P.O. Box 35285 Dallas, TX 75235-0285
Telephone: 214/634-2863 Fax: 214/634-9970
Date: _________________________ P.O. Number: ___________
| BILL TO: | SHIP TO: (if different from billing) |
| Name of Organization | Name of Organization |
| Attention | Attention |
| Billing Address | Shipping Address |
| City - State - Zip | City - State - Zip |
| Authorized Signature | Telephone: |
| Fax: |
Is your organization tax exempt? No _____ Yes _____ If yes, please submit tax exemption certificate with order.
Prices are F.O.B. Dallas, TX; shipping/handling added to invoice. Please allow 10% for shipping and handling, minimum charge of $6.50 applies. All prices are listed in U.S. Dollars. MDS accepts organizational purchase orders or pre-payment by check.
| Description | Qty. |
Each |
Total |
For software orders please specify; IBM/PC _____ Macintosh _____
All software is provided on CD-ROM unless otherwise requested.