The Military Watch Resource
FAX TO: 530.884.5966

ORDER FORM

Name:..................................................................................................................................................................................


E-Mail:.................................................................................................................................................................................
Address: (As on your credit card bill)

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Ship to address: (Only if different from billing address)

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Telephone: .................................................................................................................

Credit Card: [  ] Visa [  ] Mastercard [  ] American Express

Credit Card Number:...........................................................................................................

Expiration Date: ......................../...........................3 or 4 digit CSC Code......................

Order:...............................................................................................................................................................................

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Total price (as quoted): $.............................................................. + shipping charges
(California residents only: must pay 8.25% state sales tax) Shipping charges will be applied based on destination, weight and value of item(s).

Signature.......................................................................................................................................................................
(important)
I hereby authorize the Military Watch Resource to charge my account for the amount shown above.

Please complete, sign and fax this form back to MWR at Fax number: 530.884.5966

E-mail: Sales@Broadarrow.net