Order Form

Order Information
Send this form along with payment payable to:
Khek Brothers; 903 N. Golf Cul De Sac St.; Des Plaines, IL 60016
Or print this form and fax it to: (847) 298-8374 Phone: (847) 707-9173

Shipping Information
Shipping $5.00 for Priority Mail, $15.00 for Overnight Express Mail.

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Order Form

Description

Price

Qty.

Select one of the following:

 Shipping

 Microsoft Windows XP/2000/ME/98

 Apple Macintosh OS 7.5-10.0

 

Total.

Total.

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Shipping address

Name

Company Name

Address

City

Country

State

Zip

Email

Telephone

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Billing address

Name

Company Name

Address

City

Country

Email

State

Zip

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Billing Information

 Payment by check/money order enclosed

 Payment by purchase order (P.O)

 C.O.D. (collect on delivery)

 Contact us for payment information

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Comments / Special Instructions

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