CyGap Mail or FAX Order Form
Date: _________________FAX: 570-421-7151 / MAIL: CyGap, Inc. / POB 426 / E. Stroudsburg, PA 18301-0426 Your Full Name (as on credit card, include company name if applicable) Shipping Address : _______________________________________________Phone : ____________________ EMail : ______________________________Qty. | Product Description . . . . . . . . . . . . . . . . . Price Each . . . Amount Subtotal: $___________Shipping Cost (If Known): $_________ Order Total: $____________________Note: You may leave out the shipping cost and order total, if not known, and you will be notified of these amounts prior to shipping your order. Pym't. Method: Visa ____ MC ____ Amex ____ Novus ____ Check ____ (mailed)Card Number: ____________________________________ Exp. __________Card Holder Signature: ___________________________________________Card Holder Address: _____________________________________________Please print and mail or fax this document to the number/address shown above. You will receive an EMail or FAX confirmation from CyGap Customer Service. Note that all information must be correct and verifiable, or your order can not be processed. Thank you for ordering from CyGap, and good luck with your upgrade! sales@cygap.com | 570-421-7262 | 570-421-7262 | http://www.cygap.com Note: To check the status of your order, please DO NOT call the CyGap 800 Order Line - send an EMail with your name, to customer.service@cygap.com Close Window