Order a Pixel Monkey Product

Introductory Special
For a limited time, you can order the Pixel Monkey CD-ROM for only $19.95 plus shipping and handling. That's $10.00 Off the list price! To order call Bitwise Internet at (800) 875-1666 during business hours (8:30am - 6:00pm Eastern Standard Time, Monday through Friday), fill in the form below and fax it to us at (617) 261-7788 or order from our Web Site!

1. Product:

__Pixel Monkey CD-ROM

Quantity:

2. Shipping Information

     Name:
     Company:
     Address:
     Address2:
     State:
     Zip:
     Day Phone:
     Eve. Phone:
     Fax:
     E-Mail Address:

3. Payment Information

     Payment to be made with:
              __Visa
              __MasterCard
              __Discover
              __American Express

    Credit Card Number:
    Expiration Date :
    Name as it Appears on the Card:

4. Delivery Options

    Select shipping method:
              __Ground ($5.00)
              __Two Day ($10.00)
              __Overnight ($15.00)

5. Billing Address

(If the address where you receive your credit card bill is different from the shipping address above you must also provide your credit card billing address here.)

     Name:
     Company:
     Address:
     Address2:
     City:
     State:
     Zip:

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