Digital D254B & D404B Clock Order Form
Print and Fax to: 215.674.9338
or mail to:
Pitrone & Associates
P O Box 711
Hatboro, PA 19040
Any questions call 215.956.9797 8:30AM to 5:00PM EST  Monday - Friday
Billing Information

Name:__________________________________

Company:_______________________________

Address:________________________________

Address:________________________________

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Country:___________ZipCode:_____________

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Fax Number:____________________________

E-Mail:________________________________

Shipping Information

Name:__________________________________

Company:_______________________________

Address:________________________________

Address:________________________________

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Country:___________ZipCode:_____________

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Fax Number:____________________________

E-Mail:________________________________

2.5" Digital Wall Clock Model # D254B (s)...Quantity Ordered_______Price Each $89.00 Total__________

4" Digital Wall Clock Model # D404B (s).....Quantity Ordered_______Price Each $169.00 Total___________

Shipping prices continental U.S.A shipments.................$10.95 (1 clock)....$15.95 (2 clocks)
$20.00 (3 clocks)......$25.00 (4 clocks)

 Shipping ( continental U.S.A shipments)__________________Shipping Charge __________

PA State  6% Sales Tax (PA SHIPMENTS ONLY) ___________________Total_____________
 

Charge to my: [MasterCard]____[Visa]____[Discover-Novus]____[American Express]______

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Date:_________________

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