Order Form for Charge-N-Run(tm) PDA Charger

Fill in all sections and fax to  858-483-1096   (Your order confirmation will be sent to you by email)
 
Product
 Description
Unit Price
Qty
Total
83001
Charge-N-Run PDA Charger for Palm(tm) VII / III 
(includes charger w/ power supply, battery pack, battery door)
39.95 
    
83051
Replacement Battery Pack
15.00
    
                                  
-- Plus S&H
-- Please note: Sales tax will be charged on orders shipped to California

Bill To:

                    Name: ___________________________________________________________

                    Street / PO Box: ___________________________________________________

                    City, State Zip:_____________________________________________________

Payment Method:
(Check only one)      __  Visa          __  Master Card           __  American Express

                    Name on card:______________________________________________________

                    Card number:_______________________________   Exp Date________________

Ship To: (If different than "bill to" information)

                    Name: ___________________________________________________________

                    Street / PO Box: ___________________________________________________

                    City, State Zip:_____________________________________________________

Shipping Method: (Check only one)

                    ___  UPS Ground Residential
                    ___  UPS Ground Commercial (business addresses only)
                    ___  US Post Office Parcel Post

Contact Information:
Email:_________________________              Daytime Phone#:________________________