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Printable Order Form. Email to info@rothstein.com, or print and fax to 203.740.7401
ORDERED BY: Name ________________________________________________
Title _____________________________________________________________
Organization ______________________________________________________
Dept./Mail Station __________________________________________________
Street Address ____________________________________________________
City _________________________________ State __________ Zip _________
Country _________________________ Purchase Order # __________________
Phone ____________________________ Fax ___________________________
E-Mail Address: ____________________________________________________
Shipping Address/Instructions (If Different):
_________________________________________________________________
_________________________________________________________________
ORDER:
ITEM # / DESCRIPTION / QTY / PRICE / TOTAL /
_______/____________________________________/_____/_______/_______/
_______/____________________________________/_____/_______/_______/
_______/____________________________________/_____/_______/_______/
_______/____________________________________/_____/_______/_______/
_______/____________________________________/_____/_______/_______/
_______/____________________________________/_____/_______/_______/
_______/____________________________________/_____/_______/_______/
_______/____________________________________/_____/_______/_______/
Subtotal: _________
Handling Charge:
($7.00 Continental US/$15.00 Canada, Alaska, Hawaii, APO/FPO;
- 25% elsewhere - $15.00 minimum): _________
Rush Orders Add 15% ($25. Minimum)**: _________
Connecticut Customers Add 6% Sales Tax: _________
TOTAL: _________
** For RUSH or Foreign orders, shipping/handling are calculated at the time of
shipment, but will not normally exceed the amounts shown (and are often lower).
A surcharge may apply to some destinations, regions or countries; we may
contact you for permission if the surcharge is significant.
Email info@rothstein.com your delivery address and identify the items you are
ordering if you would like an estimate of shipping cost.
Voice: 203-740-7444 or 1-888-ROTHSTEin (888-768-4783)
PAYMENT METHOD:
___ Check or Money Order Enclosed (Payable to ROTHSTEIN ASSOCIATES INC.,
in U.S. Dollars, drawn on a U.S. Bank)
___ Discover Card ___ American Express ___ MasterCard ___ Visa
NAME ON CARD ___________________________________________________
CARD # __________________________________________________________
EXP. DATE ____________ SIGNATURE _________________________________
___ Wire Transfer (see ordering instructions)
THE ROTHSTEIN CATALOG ON DISASTER RECOVERY
THE ROTHSTEIN CATALOG ON SERVICE LEVEL BOOKS
Rothstein Associates Inc.
4 Arapaho Road
Brookfield, CT 06804-3104 USA
Fax 203-740-7401
Voice 203-740-7444
or 1-888-ROTHSTEin (888-768-4783)
E-mail info@rothstein.com
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