VIT Order Form

To order your XL slipmeter today, please print out this form (by clicking on your "PRINT" button) and fill in the following information. Then fax the completed form to me at 239/728-2304 for credit card orders.

XL Variable Incidence Tribometer Order Form
[I keep English XL Variable Incidence Tribometers in stock for immediate shipment.]

The selling price is $4,200.00 plus shipping and handling. Within the US indicate whether you want (__) ground ($50.00) or (__) overnight Shipment ($100.00).
Florida residents add 6% FL sales tax.
[If you prefer, you may order by check mailed with this form. Personal checks are okay. No Purchase Orders, however.]

For purchases from outside the US, send a bank draft for $4,400.00us, which includes second-day air freight shipping. No electronic funds transfers will be accepted for international orders, but Mastercard and Visa charge cards are acceptable. If you want to use your own shipper, there is no discount for shipping and handling. Send the shipping papers filled out showing billing to you.

Ship my English XL slipmeter to the following address:

Name_______________________________________________

Address______________________________________________

City_____________________State_____ZIP_________Country_________

Your name______________________________________________

Please charge my XL slipmeter purchase to my (__) Visa or (__) Mastercard account. [Other bankcards not accepted]

Credit Card Number__ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __

Expiration Date __ __ / __ __

The name as it appears on the card_____________________________________

Your phone number___-___-________

Signature of purchaser X___________________________________ Date___________

Or you may mail the completed form to me with a check or bank draft to:
William English, Inc.
P. O. Box 985, Alva, FL 33920 USA

| My Federal Tax I.D. number is 65-0372510 |

If you have questions, call me at 239/728-3254