Place An Order

Name________________________________________________________________________________
Billing Address________________________________________________________________________
Shipping Address______________________________________________________________________
Product #__________________ Quantity___________ Finish___________________________________
Method of Payment: Visa or Mastercard #____________________________________________________
Expiration Date_____________ Authorized Signature__________________________________________
Price per Unit_________________________________________________________________________
Total Purchase Amount_________________________________________________________________
Tax (7% GA resident) ___________________________________________________________________
Shipping (call for quote) _________________________________________________________________
GRAND TOTAL _______________________________________________________________________

Brochure Request: STORAdisc____ STORAvid____ STORAmedia____ STORA-LP/LD____

			290 M.L. King Jr. Drive, SE Suite A5 Atlanta, GA 30312-2100 800.848.9811 404.659.5041 fax info@storadisc.com

	davidson-whitehall ORDER FORM & INFORMATION REQUEST
	To Place An Order or Request Complimentary Brochure Information Please PRINT OUT and Complete the Form Below and fax to 404-659-5041 or mail to 290 M.L. King Jr. Drive, SE, Suite A5, Atlanta, GA 30312-2100. VISA or Mastercard are accepted, or send check or money order. Please allow 6-8 weeks for delivery. A 5% discount is offered for orders of 3 or more of the same unit size and finish. STORAdisc, STORAvid, and STORA-LP/LD units are shipped in 2 cartons. STORAmedia units are custom packaged. A one-year warranty is provided against defects in materials and workmanship.
	Name________________________________________________________________________________ Billing Address________________________________________________________________________ Shipping Address______________________________________________________________________ Product #__________________ Quantity___________ Finish___________________________________ Method of Payment: Visa or Mastercard #____________________________________________________ Expiration Date_____________ Authorized Signature__________________________________________ Price per Unit_________________________________________________________________________ Total Purchase Amount_________________________________________________________________ Tax (7% GA resident) ___________________________________________________________________ Shipping (call for quote) _________________________________________________________________ GRAND TOTAL _______________________________________________________________________ Brochure Request: STORAdisc____ STORAvid____ STORAmedia____ STORA-LP/LD____