Product Order Form
 
Product NameCategoryQuantityPriceSubtotal
     
SUB TOTAL  
8.25% TAX ON SUBTOTAL (for Texas residents only)  
SHIPPING & HANDLING  
TOTAL  
TYPE OF PAYMENT: ____ CHECK ___ CREDIT CARD: VISA    MASTERCARD    AMEX
CREDIT CARD NUMBER:__________________________  EXP. DATE:____________

SHIPPING & HANDLING TABLE
(Standard delivery in 10 business days and express delivery in 2 business days from receipt of full payment)
Total Items Standard Fed Ex 2nd Day
0 - 9999$0.00$0.00$0.00

make checks payable to:


Foundation Management Services, Inc.
1330 Teasley Lane, Suite 101
Denton TX 76205
Phone: 940-243-5858
Fax: 940-380-9605
NAME:

AGENCY:

ADDRESS:

CITY / STATE / ZIP:

PHONE / FAX:

E-MAIL: