Distributor Name:

Your Business Name
(Leave blank if none.):

Distributor E-mail:

Distributor Telephone
(In case we have questions.):

Your Mailing Address:

Label package with your return address?

No Yes

Which NHBC package / program do you own?

-- Select An Option -- The Fast Cash CD-ROM System The Business In A Box The Business Six Pack The Internet Web Site / Mall I am not currently a Distributor. Other

Customer Name:
(This information will be shipped to this customer.)

Ship-to Address:

# of CD’s Ordered?

Shipping more than one CD?
Indicate CD’s in the Additional Information field below.

Only shipping one CD-ROM title in this order?
Indicate the title below.

Title:

-- Select An Option -- Advertising Made Easy CD-ROM eBay Auctions Made Easy CD-ROM Business Letters and Forms Made Easy CD-ROM Greatest Computer Games CD-ROM Instant eBook Library CD-ROM Windows Made Easy CD-ROM Computer Learning Made Easy CD-ROM Internet Made Easy CD-ROM Made Easy Series 3 CD Pack Instant Publisher PLATINUM CD-ROM Start Your Own Business CD-ROM Business Success Toolbox CD-ROM Internet Power Tools CD-ROM 593 Business Letters CD-ROM CIA World Fact Book CD-ROM SBA on CD-ROM Guide to Import/Export CD-ROM

Postage:
(How much did your customer pay for shipping? Use the Media Mail option if your customer did not pay.)

Shipping costs are FLAT RATE at $2.00 / $4.00 per customer.

-- Select An Option -- $2.00 Media Mail (7-10 business days) $4.00 Standard Shipping (3-5 business days) Other Amount (Indicated Below)

Additional Information:
(Indicate additional titles, qty’s, postage requirements, etc.)

 
 Please fill out and submit this form for each order you want shipped.

 If this is your first order, be sure to call Customer Service at 1-503-521-9217
to pay for postage after you submit it.