ORDER FORM
Call 208-756-2819 or Contact: sales@kmc-computers.com
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Please provide the following ordering information:

QTY	DESCRIPTION

	BILLING
Credit Card	VISA MasterCard American Express Diner's Club Discover
Cardholder Name
Card Number
Expiration Date

	SHIPPING
Name
Street Address
City
State/Province
Zip/Postal Code
Country

Please provide the following contact information:

Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail