Mail In/Fax Order Form

Instructions: Print this form on your printer using your Web browser. Complete the shipping information below and fill in the total amount for your order. Credit card customers, please be sure and include your signature. Please print all other information legibly. Please do not send cash. Send this form with payment to:

Starstone Software Systems, Inc.
PO Box 950478
Lake Mary, FL 32795-0478

You may also FAX this page to: 407-324-0105

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Name:         _______________________________________

Address:      _______________________________________
 

                  _______________________________________
 

City:           ____________________ State: ____________
 

                                                             Zip:  ____________

Email:  ____________________________________________________

Phone (in case we have problems with your order): __________________

Security Code from back of card: _______________
(See http://www.starstonesoftware.com/eots/cvv2.htm if you don't know what this is).

Eye of the Storm™  3000 CD ROM                    $39.95
Shipping and Handling                                             $4.95
Sales Tax (Florida Residents only $3.14)
                                                                       _________
Total:                                                              

Payment Method:

____ Check/Money Order    ____ Visa   ____ Master Card   

____ Discover/Novus         _____ American Express

Card # ______/______/______/______      Exp. Date: ________________

Signature: ___________________________________________________