Fax/Mail Order Form

R2109B, TianshengMingYuang, No.111, ShipaiWest Road, Guangzhou, China.510630
+86 (20 ) 8759 7156

Bill To:

Company :
Name :
Address :

E-mail :
Phone No :

Ship To:

Company :
Name :
Address :

E-mail :
Phone No :

Payment Method/VISA, MC, DISCOVER, AMX, Check, Money Order	Card Number/	Exp. Date(mm/yyyy)/
Card ID(3digits)/	Card Holder Signature

Order Date/	Last Modified Date/	Ship Date /	Remarks/
Status/ Pending, Shipped, Incomplete, Canceled	Shipping Carrier(UPS,USPS)	Shipping Method(see below)	Tracking #/

Qty	Item Description (name, Item #, size)	Unit Price	Total

Please print out and fax or mail to us.

Shipping Method:

UPS - Next Day Air, 2nd Day Air, Ground, 3 Day Select, Worldwide Express
USPS - Priority, Express, Global Express mail (EMS)


Mail to: R2109B, TianshengMingYuang, No.111, ShipaiWest Road, Guangzhou, China.510630		Fax: to 86- 20-8759-7357

Contact email: sales@poweremb.com Tel: 86 (20) 8759 7156 Fax: 86 (20) 8759 7357