Use The Mail-In Order Form Below To Pay By Check
Printer: Print out this order form page and complete.
No Printer: Copy the information on a blank piece of paper.


Payment Method:

Money Order or Personal Check


You have ordered:
1 (one) Universal TV/WebTV Remote Control

  Product price    .....................     6.00

  Product s + h    .....................       4.95

  Total price        .....................   $ 10.95



~~ ORDER FORM (please print clearly) ~~



Name:_________________________________________


E-Mail:________________________________________


Street Address:_________________________________

_______________________________________________


City/State/Zip Code:______________________________

_______________________________________________


Send Amount Due ( $ 10.95 ) To:
~~~
WILLIAM STEELE
19 Ballard St. Suite G
Easthampton, Ma. 01027

Make checks payable to: WILLIAM STEELE ~ Thank You For Ordering!