SEAK, Inc. ORDER FORM
                                                                                                        Priority Code: Net

To order call SEAK, Inc. at 508-457-1111, or Print & complete this form (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.) 3 or 4 digit credit card security code:
  Credit Card Billing Type of card: ___Visa ___MC ___AE
Card No.
 		 Exp. Date:    ____/____
Signature
Name
Name of Organization
Address

 
Billing Address (if different than Shipping Address)
City                                                                           State                        Zip
Phone                                                                        Fax
E-Mail address

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