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ORDER FORM
Starting a Home Based Mail Order Business Software
Pay Only $39.95

ORDER SECURELY ONLINE..

CLICK HERE to place a Secure Order with us. With secure ordering, your Credit Card and other Private Information is encrypted in transit so no one can use a Sniffer Program to intercept the data and use it. In other words, you're guaranteed a safe, online shopping experience.

ORDER SECURELY WITH PAYPAL..

TO ORDER BY MAIL
1. Complete, print, and then fill in appropriate sections.
2. Mail or Fax us your check or credit card order.

	PURCHASER INFORMATION
Name:
Company:
Email:
Phone:	Fax:
Address 1:
Address 2:
City:
State/Prov:
Zip/Postal:
Country:

	PRODUCT PRICING
	Item Mail Order Software		Qty	$ ea.	$ Total
	Sub-Total:
	Select Shipping & Handling: $3 Stndard $14 Next Day $24 Outside USA
	TOTAL ENCLOSED (including S&H) $

	SEND YOUR ORDER TO:
	R&L Enterprises 6342 McCollum Ln. Acworth, GA. 30102 Ph# 770-974-0574 Fax# 770-975-0445 Questions? E-Mail us at R&L Enterprises.net

	PAYMENT OPTIONS
	BY CREDIT CARD (MAIL or FAX)
	Complete below if paying by Credit Card.
	Select a Credit Card:
	Visa	Mastercard	Amex	Discover
	Name as on card: Credit card number: Expiration: Month: ar: Authorization: Type ("I AGREE")

BY CHECK (MAIL or FAX)
COMPLETE YOUR ACCOUNT INFORMATION:

Note: All fields must be completed. Fraudulent use of BANK information is strictly
prohibited by State and Federal Laws. ALL transactions are logged and any
fraudulent activity reported. If time is important to you, use your Credit Card to Order
since this process is quicker.

Enter all the numbers on the bottom of your check (use spaces for odd characters):
_______________________________________

Name on check:___________________________________

Address on check:________________________________

City:_______________  State:_________  Zip:______

Day/Night Phone #'s:_______________ /____________

What is the FULL check number:___________________

Total Check Amount This Order: $_________________

YOUR BANK INFORMATION:
s

Name of Bank:____________________________________

Bank Branch Name or Number:______________________

City:__________________  State:_____  Zip:_______

Phone# of Bank (if not on check)_________________

Enter 9 digit routing #:___________ (see diagram)

Bank account#:___________________Date:___/___/___

VOIDED COPY OF CHECK MUST ALSO BE FAXED
Please FAX to (770) 975-0445 after you have completed the form.

1. All fields must be filled in. If they are not, orders may not be processed.
2. ALL BAD CHECKS WILL BE CHARGED A $25.00 FEE. NO EXCEPTIONS !