Order Form

SEAK, Inc. ORDER FORM ORDER FORM

Priority Code: Net

To order call SEAK, Inc. at 508-457-1111, or Print this form and complete the requested information (neatly, please), and
Fax to: SEAK, Inc. at 508-540-8304, with credit card information.
Or mail with credit card information or check to:
SEAK, Inc. PO Box 729, Falmouth, MA 02541

Quantity	Item SKU #	Description	Amount



	Shipping	Shipping & Handling $9 per order. Sales Tax: 5% if shipped to MA
	Total

Payment Type

	Check Enclosed (made out to SEAK, Inc.)
	Credit Card Billing	Type of card: ___Visa ___MC ___AE
Card No.		Exp. Date:
Signature

Please print or type all information. Use abbreviations as necessary.

Name

Name of Organization

Address

City                                                                           State                        Zip

Phone                                               Fax

E-Mail address

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