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Quote/Order Form

Cyber Grafix Designs

This is a Quote/Order form. This is not a binding agreement or a promise to buy.
It is just a form that gives us enough information to contact you. We will respond by
email first,then call if needed. The price is only binding to you with the offer number given.

Please provide the following contact information:

First name
Last name
Street address
City
State/Province
Zip/Postal code
Country
Home Phone
E-mail
URL

Please provide the following ordering information:
Place 0 in the blank boxes please.

QTY DESCRIPTION

Descriptions for above items. Please be as specific as possible. Fonts colors,sizes of buttons or images. etc.


Please fillout all boxes, if you leave blanks you will get an error. This will not effect the sending of the form. This is not a secure connection. DO NOT Give credit card or Purchase order information in this form. Only click on the submit button one time. you may reset the form after submiting.Thank you for your Interest in our products.

Click on the home button after you have submited the form.
Copyright 1999 Cyber Grafix Designs.
A Holzhauser Production.