The Planner Order Form

Please fill out and send in the following order form along with credit card 
information, a check or money order for $199.00 plus $6.00 (Shipping & Handling) to:
                            The Planner
                            Scott Office Solutions
                            538 Wachob Drive
                            Punxsutawney, Pa. 15767
                            E-mail: theplanner@scottofficesolutions.com

First Name:___________________________ Last Name:____________________________

Business Name:_______________________________________________________________

Address:_____________________________________________________________________

Address:_____________________________________________________________________

City:_________________________________ State:______ Zip Code:________________

Phone Number (required):_____________________________________________________

E-mail address (required):___________________________________________________

Payment Method: Check____ Money Order_____ Credit Card_____

     Credit Card (MC, VISA, Discover, Am. Express)_____________
         
         Card Number: _________________________________________

         Billing Name: ________________________________________
         
         Billing Address:______________________________________
                  
               ________________________________________________
                                                   													
Planner on CD:

   VERSION                  # of Copies

 Network Version  ($199.00)      ___ 
 Individual ($49.00)             ___ 
    
 TOTAL PRICE    =      _____________

Shipping & Handling:          $6.00 (each)    =    _____________

                            TOTAL ENCLOSED    =    _____________

Special Instructions:____________________________________________

_________________________________________________________________                            

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