QUALITY KIT'S ORDER FORM ~ 1 888 464 5487 (888 GO 4 KITS)
49 McMichael St, Kingston ON., K7M 1M8
Fax number:  1 613 544 4944

Please use this form to order kits, parts, or catalogs.

NAME: Olivier Nicole                        ADDRESS:AIT / CSIM Program
58 Moo 9, Paholyothin Road Km 42
Klong 1

CITY: Klong Luang        PROVINCE/STATE: Pathumthani               COUNTRY: Thailand

POSTAL/ZIP: 12120                     PHONE: +66 2524 5708             E-MAIL: on@cs.ait.ac.th
                                                               (important)

If you require Next Day or 2nd Day freight, please indicate this in the freight section of the order form.
                           Next day to USA -->$15 USD         2nd Day to USA -->$10 USD
Quantity Order Code Description Price Total    
  1   QK74   PC Parallel Port Relay Board   49.99   49.99    
             
             
             
             
             
    Canadians add $10.00 for shipments under1lb.        
    Americans add $15 CDN or $10.00 U.S for shipments under 1lb        
Orders over1 pound, please call for shipping quote.                                                  Subtotal:     49.99    
This is to certify that I am over the age of 16 and wish to purchase the products you have advertised.  I hereby authorize Quality Kits to debit my credit card for the amount of this order. Signature:__________________________________ GST 7%:   Canadian residents
PST 8%   Ontario residents
Card # 3763 090586 91008 AMEX
EXP:09/04 		Shipping:   38:00  
Signature__________________________ Total: CA $ 87.99  
Please join an invoice to the shipment!