Name: __________________________________________________________________________________ Company: __________________________________________________________________________________ Address: ______________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ City, State, Zip: ______________________________________________________________ Day Phone: ______________________________ Cost of WHITEFLY is $30, which includes diskettes, and printed documentation in a 7"×9" binder. Shipping and handling within the United States is $5. Call or e-mail for international shipping, special handling, or multiple orders.
Make checks or money order payable to Formedia, Inc. MasterCards and Visa credit cards acceptable MasterCard/Visa _________-_______-________-_________ Expiration date _______________________ Signature __________________________ |