Striking Images Screen Saver Order Form
4685 West Crestview Circle - Tucson, Arizona 85745 - (520) 743-9964

Ordered By:
All correspondence will be sent to this address unless otherwise specified.

Name:_______________________________________

Street:_______________________________________

City:_____________________St:____Zip:__________

Phone:_______________________________________

Email :_______________________________________

Ship To:
Fill in only if different from "Ordered By."

Name:_______________________________________

Street:_______________________________________

City:_____________________St:____Zip:__________

Phone:_______________________________________

Select Payment Type:

CheckMoney Order

MasterCardVisa

Account Information:

Card #:___________________________Exp:______

Signature_______________________________
Program Quantity Price Total
Lightning Screen Saver MegaPack   (Internet Download)   $ 15.95  
Lightning Screen Saver Volume 1     (Internet Download)   $ 10.95  
Lightning Screen Saver Volume 2     (Internet Download)   $ 10.95  
Lightning Screen Saver Volume 3     (Internet Download)   $ 10.95  
Sunset Screen Saver MegaPack          (Internet Download)   $ 10.95  
       
Lightning Screen Saver MegaPack      (Delivered on [ ] Floppy or [ ] CD)   $ 19.95  
Lightning Screen Saver Volume 1       (Delivered on [ ] Floppy or [ ] CD)   $ 15.95  
Lightning Screen Saver Volume 2       (Delivered on [ ] Floppy or [ ] CD)   $ 15.95  
Lightning Screen Saver Volume 3       (Delivered on [ ] Floppy or [ ] CD)   $ 15.95  
Sunset Screen Saver MegaPack           (Delivered on [ ] Floppy or [ ] CD)   $ 15.95  
       
Lightning Poster   $ 15.00  
Arizona Poster   $ 15.00  

SHIPPING OPTIONS

TOTALS
USPS
FedEx 2nd Day
FedEx Overnight		 $4.50
$8.00
$10.00		 Total
(all columns)

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Sales Tax
(AZ residents) Add 5%

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Shipping
(select an option)

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Please remember to select Floppy or CD option if you are not requesting Internet delivery. Internet download information and program passwords will be shipped as soon as payment is verified. Arizona residents must include sales tax.
TOTAL ENCLOSED


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