SAFE Collecting Internet Order Form
Please print this form and send it to the address shown below:
Customer Code No.(if known)_____________ Date of Order _______________

Please provide your street address for UPS delivery, if possible (PO Box for APO ok)

Bill to:____________________________________ Ship To:___________________________________

Address:___________________________________ Address:__________________________________

City:______________________State___ Zip______ City___________________ State___ Zip_______

Phone (Home)________________   Phone (Work)_______________   Fax__________________

**Please note: In "Quantity" column, state total number of pages, cards, etc. NOT packages**

6090.jpg (1801 bytes) Special Offer: Black Photo Album with 28 pages for 56 photos up to size
5 x 7". Front cover accepts up to 4 x 6" prints. Size: 6-5/8 x 8-1/2 x 1-1/4" thick. Fits easly in purse. Retail value $ 17.95. Special: No. 6091 =$ 6.00 Limited time only.
  If you wish to receive this album, please check the following box  ] and add below.

Total of Merchandise_____________
Shipping and Handling (Continental USA only): Under $ 100 add $ 10.50;

from $ 100.01 to $200 add $ 11.50;  from $ 200.01 to $ 300 add $ 12.50.
FREE shipping over $ 300 _____________
Sub Total _____________
PA Residents Add 6% Sales Tax to Sub Total_____________
Total_____________

Please Indicate Method of Payment:
Check or Money Order ____ All major Credit Cards($20 Minimum) ____
Available at Additional Cost (Please Mark): Next Day Air ____ Second Day Air ____

Card Number __________________________________ Exp Date _____________
3-or 4-digit Security Code on front or back of card _________

Name as it appears on Card _______________________ Signature______________________

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Please print this form and send it to your favorite dealer or to: SAFE Publications, Inc.
P.O. Box 263-E, Southampton, PA 18966; Tel (215)357-9049 - Fax: (215) 357-5202

Prices and specifications are subject to change without notice.
Trademark registered by SAFE Publications, Inc. Copyrighted 2006 by SAFE Publications, Inc.
For Information: sales@safepub.com or call (215) 357 9049, Fax (215) 357 5202
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