theGadget Corner1505 Old Deerfield Road, Ordering Information

ORDER FORM
Please print out to use as you view our catalog.

ORDERED BY:

SHIP TO: (If different from left)

Name:______________________________

Street:_____________________________

City:_______________________________

State, Zip Code:______________________

Business: or Residence:

Name:______________________________

Street:_____________________________

City:_______________________________

State, Zip Code:______________________

Business: or Residence:

Daytime Phone Number:_______________________
(Your information is confidential and will only be used to contact you about or with, your order.)

	Item #	Product Description	Color	Qty	Cost Ea.	Total
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				SUBTOTAL
				ADD SALES TAX (8.5% within IL)
				SHIPPING CHARGE (see table below)
				TOTAL

To Order:
Please send check or money order to:

the GADGET CORNER
1505 Old Deerfield Road
Highland Park, Illinois
60035, USA

We look forward to serving you!

G A D G E T 1505 Old Deerfield Rd.		C O R N E R TM Highland Park, IL 60035