HERZOG Keyboarding 801 E. Cam. de los Padres Tucson, AZ 85718 Ph (520) 792-2550 Fx (520) 792-2551

Method of payment: ____ Check enclosed ____ Credit Card ____ Purchase Order:          P.O #_________________

For Grades	Use	Product #	Unit Price	Quantity Ordered	Line Total
Thru Grade 6	Elementary	GE	$30.00
Grade 6+	Secondary	GS	$30.00
Sales Tax 7.6% (Arizona Only)
Shipping/Handling ($6.00 each to addresses in U.S.)
TOTAL

Credit Card Information

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__(_______)__________________________ Phone (Day) __(_______)__________________________ Phone (Evening) __(_______)__________________________ Your Fax Number ____________________________________ Your E-mail Address Ship To:

____________________________________ Name of School or District ____________________________________ Address ____________________________________ City/State/Zip ____________________________________ Your Position __(______)___________________________ Phone

____________________________________ District/School ____________________________________ Address ____________________________________ City/State/Zip ____________________________________ Attn:

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