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FAST  ACTION  FAX ORDER   FORM  -  EXPORT-LEADS

1-YEAR ONLINE SUBSCRIPTION SERVICE - WORLDWIDE    US$95.00
NAME:
COMPANY:
ADDRESS:
CITY-STATE:
POSTAL CODE:
COUNTRY:
EMAIL ADDRESS:
TELEPHONE:

We are enclosing our check/money order for US$ drawn on a US bank.
We have transferred US$ to your account at:
           Bank of America, 19255 Jensen Way, Poulsbo, Washington 98370, USA. (INTERDATA Account #0000-63156-418 ABA/Routing #0260-0959-3)

We wish to use the following credit card:    creditcards.jpg (8677 bytes)    

NAME ON CARD:
CARD NUMBER::      EXPIRATION DATE:

PLEASE COPY ORDER FORM ON YOUR PRINTER,
THEN FAX ORDER FORM TO: FAX: (1) 360 697-4696 OR TELEPHONE (1) 360 779-1511 OR CALL TOLL FREE (1) 800 818-0140 (USA & Canada)
OR MAIL TO: THE INTERNATIONAL DIRECTORY OF IMPORTERS, 1741 KEKAMEK , POULSBO, WASHINGTON 98370, U.S.A.

THANK YOU FOR YOUR ORDER!

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