Order Number:

Name (please print)_________________________________________________________

Address ____________________________________________________________________

City ______________________ St./Prov. ________________ Zip Code ____________

Country (if not USA) __________________ Phone _____________________________

Email address __________________________________

Quantity

Item Number

Description

Price

 

 

 

 

 

 

 

 
       
   

Subtotal:

  
   

Shipping/Handling:

  
   

(Michigan residents MUST add correct sales tax) Tax:

  

 

 

Total:

 

Note: Payment must be in U.S. dollars, drawn from a U.S. bank.

Please do not send cash!

Payment type:

[] Check

[] Money Order

Make checks payable to "Micronet Technologies".

Mail To:

Micronet Technologies
 

P.O. Box 523
 

Byron Center, MI 49315

Phone: (616)583-1990

All prices subject to change without notice. All items subject to availability.

Thank you!