Thoughtful Creations Purchase Order
Form
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Product | Qty | Each | Total Price | ||
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Genbox Family History 3 - Download Only | |||||
Single-user license by Email | _____ | 29.95 USD | ____________ | ||
Genbox Family History 3 - Delivery on CD | |||||
CDROM mailed to address below | _____ | 39.95 USD | ____________ | ||
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Ohio residents only -- please add 6.5% Sales Tax: |
____________ | ||||
TOTAL (USD): | ____________ | ||||
If paying by Credit Card - Credit Card Number: |
______________________________ | ||||
Expiration Month / Year: |
_____ / _____ | ||||
Card Verification Value: |
_____ (last 3 or 4 digits in signature area on back side of card) | ||||
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BILLING ADDRESS: |
SHIPPING ADDRESS (if different): | ||||
|
FIRST NAME | ______________________ | FIRST NAME | ______________________ |
LAST NAME | ______________________ | LAST NAME | ______________________ |
COMPANY | ______________________ | COMPANY | ______________________ |
ADDRESS 1 | ______________________ | ADDRESS 1 | ______________________ |
ADDRESS 2 | ______________________ | ADDRESS 2 | ______________________ |
CITY | ______________________ | CITY | ______________________ |
STATE/PROVINCE | ______________________ | STATE/PROVINCE | ______________________ |
ZIP/POSTAL CODE | ______________________ | ZIP/POSTAL CODE | ______________________ |
COUNTRY | ______________________ | COUNTRY | ______________________ |
PHONE | ______________________ | ||
EMAIL ADDRESS | ______________________ | ||
DATE | ______________________ | ||
Please mail payment and this order form to: | |||
THOUGHTFUL CREATIONS PO BOX 58637 CINCINNATI, OH 45258 USA |
Payments sent to this
address must be in the form of a U.S. bank check drawn on
U.S. funds, an international money order, or by VISA, Mastercard,
Discover, or
American Express.
Thank you for your order!