Order
Online
All of the
items you see on this web site can be ordered online.
Simply click on the "Add to Your Shopping Cart" button
next to the item you wish to purchase, and then follow
the instructions to complete your order using our
secure shopping cart.
Order
by Fax or Mail
To order by
fax or mail, simply print this form, print or type the
information requested, and then fax it to (414) 352-5679
or mail it to Crestwood Communication Aids, Inc.; P.O.
Box 090107; Milwaukee, WI 53209-0107; USA.
Thank
you for your order!
To continue
exploring our web site after you have printed the form,
either hit the "back" button on your browser or scroll
down to the bottom of this page and click on any link to
go directly to another section of the
site.
1.
SHIP TO: (You must use a street address -- and not a
P.O. Box No. --
for UPS delivery)
Name
________________________________________________________
Institution
_____________________________________________________
Address
______________________________________________________
City
__________________________________________________________
State/Province
___________________________ Zip
__________________
Country
_______________________________________________________
All orders
must include phone number
(
_____
) ____________________________________________________
Fax number (
_____ )
____________________________________________
When is the
best time for us to call you - from 9 a.m. to 5 p.m.
Central Standard Time - if there are any questions?
_________________________________________
2.
REMINDERS: FED.
I.D. NO. 39-0759578
4.
PHONE (414) 352-5678 or FAX (414) 352-5679 TO SPEED YOUR
ORDER. Charge
to VISA or MasterCard.
5.
PAYMENT METHOD ($25.00
Minimum Merchandise
Order):
___ Check or
money order enclosed. (NOTE: Telecheck charges fees
for returned checks.) Add delivery charges.
___ Charge to:
___ VISA ___ MasterCard ___ Add delivery
charges.
Name of Bank
______________________________ Expiration Date
____________
Card Number
________________________________________________________
3-Digit
Verification Number (on Back of Card)
_____________________________
Print Name
Appearing on the Card
______________________________________
Your Signature
(All orders MUST be signed)
_______________________________
Check here
___ I have read the reminders above and the
return policy below.
6.
RETURN POLICY:
