Please print this form, complete all fields below, and be sure to enclose Cash, Check*, or Money Order in the proper amount payable to Simurgh Prime. 

Mail to:
Simurgh Prime
259 Kiefer Drive
Dept. W
Montgomery, AL  36109

Please Print Clearly

Name

 

Address

 

City, State  ZIP

 

Phone

 

Email Address

 

 

Series

Description

Suggested Retail Price

OUR PRICE!

Check (X)

1000 Series
(21 Reports)

Business Report Collection 1

$210

$20

 

1500 Series
(25 Reports)

Health and Welfare Report Collection

$50

$10

 

2000 Series
(25 Reports)

Business Report Collection 2

$250

$20

 

All Three Series

Order all three series and Save 40%

$510

$30

 

Please Circle One

Media

Shipping

Price

 

Option 1

3.5" Floppy Disk

US Mail

$1.00

 

Option 2

3.5" Floppy Disk

Federal Express

$9.00

 

Option 3

Electronic Mail

N/A

N/A

 

Verify Email Address

 

Total

 

 

Make your Check or Money Order payable to Simurgh Prime.
Please allow 10 to 14 days for delivery of US Mail.

*Orders paid by check will be shipped the day your check clears.  We apologize for any inconvenience, but everyone is not as honest as you and me. ;-)

THANK YOU FOR YOUR ORDER!


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