A SERVICE OF

logo

No. Users Unit Price Quantity Total Price
1 79.99 ________ $_____________
5 69.99 ________ $_____________
10 59.99 ________ $_____________
20 49.99 ________ $_____________
40 39.99 ________ $_____________
100 29.99 ________ $_____________
Shipping
& Handling 5.00 $_____________
TOTAL $_____________
[ ] Check/Money Order enclosed [ ] Charge credit card
[ ] AmEx [ ] MasterCard [ ] Visa
Account #:__________________________________________________
Expiration Date:____________________________________________
Name:_______________________________________________________
Address:____________________________________________________
City/State/Province:________________________________________
Country/Postal Code:________________________________________
Telephone:_______________________________________ [optional]
Email Address:___________________________________ [optional]
How did you hear about Irie Pascal?_________________________
_________________________________________________ [optional]
[ ] Tick this box to join the Irie Pascal mailing list.
Please do not send cash. Make checks or money orders payable to Irie Tools. All prices are quoted in US$ and are
guaranteed until December 31, 2005. Please allow two to four weeks for delivery. If you fill in your email address you will be