WSO ORDER FORM WSO, PO Box 9999, Van Nuys, CA USA Tel Website: Fax

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1 WSO ORDER FORM WSO, PO Box 9999, Van Nuys, CA USA Tel Website: Fax DESCRIPTION LANGUAGE ITEM QUANTITY UNIT PRICE TOTAL

2 Single Purchase Discounts $.01 $ = 0% $ $2, = 6% $2, $4, = 7.5% Shipping and Handling Fee Schedule $.01 $25.00 add $2.50 $25.01 $50.00 add $3.50 $50.01 $ add 7% $ and up add 6% MAKE CHECKS PAYABLE TO NAWS, INC. All purchases from outside the US must be made by Cashier's Check or Money Order drawn in US currency, or the equivalent in Canadian currency. SUBTOTAL Subtract Discounts (When applicable) Add Shipping and Handling Fee (See schedule) Add Sales Tax ORDER TOTAL (California orders only) CREDIT CARD PURCHASE: PLEASE PRINT ALL INFORMATION. YOU MAY FAX YOUR CREDIT CARD ORDER. VISA AMERICAN EXPRESS MASTER CARD DISCOVER CARD DINERS CLUB CREDIT CARD NUMBER EXPIRATION DATE LAST NAME OF CREDIT CARD HOLDER FIRST NAME SIGNATURE DATE BILL TO: PLEASE PRINT ALL INFORMATION. DO NOT ABBREVIATE STREETS OR CITIES. SHIP TO: PLEASE PRINT ALL INFORMATION. DO NOT ABBREVIATE STREETS OR CITIES. CUSTOMER ID (found in the upper right corner of invoice) NOTE: SHIPMENT BY DHL OR FEDERAL EXPRESS IS AT CUSTOMER'S EXPENSE. NOTE: DELIVERIES TO PO BOXES MUST BE PICKED UP WITHIN SEVEN DAYS OR THEY WILL BE RETURNED TO THE WSO. RETURN SHIPPING WILL BE AT CUSTOMER'S EXPENSE. THANK YOU FOR YOUR COOPERATION. ALL PRICES ARE SUBJECT TO CHANGE WITHOUT NOTICE If ordering for a group, area, region, treatment or correctional facility, please indicate. Indiv./Grp. Area Region Organization NAME 7/03

3 WSO EUROPE ORDER FORM 48 RUE DE L ETÉ, B-1050 BRUSSELS, BELGIUM Tel. +32/2/ Fax +32/2/ wso-europe@na.org DESCRIPTION LANGUAGE ITEM QUANTITY UNIT PRICE TOTAL

4 Mail Order to: WSO Europe 48 Rue de l' Eté B-1050 Brussels, Belgium Tel. +32/2/ Fax +32/2/ Single Purchase Discounts $.01 $ = 0% $ $ = 9% $ $ = 15% $1, or more = 21% Shipping Schedule For orders less than US$200 add shipping 10% of order For orders more than US$200 Shipping billed at cost by WSO Europe TOTAL PRICE OF ORDER Subtract Discounts Freight 14-K Gold Medallion Shipping/Insurance Fee $10.00/Medallion Shipped separately via Federal Express, insured for $ For international shipments, please call the WSO for shipping costs. ORDER TOTAL CREDIT CARD PURCHASE PLEASE PRINT ALL INFORMATION YOU MAY FAX YOUR CREDIT CARD ORDER VISA AMERICAN EXPRESS MASTER CARD DISCOVER CARD DINERS CLUB CREDIT CARD NUMBER EXPIRATION DATE LAST NAME OF CREDIT CARD HOLDER SIGNATURE FIRST NAME DATE Bill to: PLEASE PRINT ALL INFORMATION. PLEASE INCLUDE A DAYTIME PHONE NUMBER. DO NOT ABBREVIATE STREETS OR CITIES. NAME PHONE STREET ADDRESS CITY COUNTRY POSTAL CODE PLEASE PRINT ALL INFORMATION. PLEASE INCLUDE A DAYTIME PHONE NUMBER. DO NOT ABBREVIATE STREETS OR CITIES. Ship to: NOTE: DELIVERIES TO PO BOXES MUST BE PICKED UP WITHIN TWO WEEKS OR THEY WILL BE RETURNED TO THE WSO-EUROPE. RETURN SHIPPING WILL BE AT CUSTOMER'S EXPENSE. THANK YOU FOR YOUR COOPERATION. NAME PHONE STREET ADDRESS CITY COUNTRY POSTAL CODE CUSTOMER ID (Found in the upper right corner of invoice) If ordering for a group, area, region, treatment or correctional facility, please indicate. Indiv./Grp. Area Region Organization NAME ALL PRICES ARE SUBJECT TO CHANGE WITHOUT NOTICE 7/03

5 WSO ORDER FORM TO BE USED IN LATIN AMERICA WSO, PO BOX 9999, VAN NUYS, CA USA Tel Fax Website DESCRIPTION LANGUAGE ITEM QUANTITY UNIT PRICE TOTAL

6 Mail order to: World Service Office PO BOX 9999 Van Nuys, CA USA Tel. (818) Fax (818) Single Purchase Discounts $.01 $ = 0% $ $ = 23.5% $ $ = 25% $1, or more = 27% Shipping Schedule For orders less than $500 add 10% For orders more than $500 charges will be billed. MAKE CHECKS PAYABLE TO NAWS, INC. All purchases must be made by Cashier's Check or Money Order drawn in US currency. TOTAL PRICE OF ORDER Subtract Discounts Add Shipping and Handling Fee 14-K Gold Medallion Shipping/Insurance Fee $10.00/Medallion Shipped separately via Federal Express, insured for $ For international shipments, please call the WSO for shipping costs. ORDER TOTAL CREDIT CARD PURCHASE: PLEASE PRINT ALL INFORMATION. YOU MAY FAX YOUR CREDIT CARD ORDER. VISA AMERICAN EXPRESS MASTER CARD DISCOVER CARD DINERS CLUB CREDIT CARD NUMBER EXPIRATION DATE LAST NAME OF CREDIT CARD HOLDER FIRST NAME SIGNATURE DATE Bill to: PLEASE PRINT ALL INFORMATION. DO NOT ABBREVIATE STREETS OR CITIES. Ship to: PLEASE PRINT ALL INFORMATION. DO NOT ABBREVIATE STREETS OR CITIES. CUSTOMER ID (found in the upper right corner of invoice) NOTE: SHIPMENT BY DHL OR FEDERAL EXPRESS IS AT CUSTOMER'S EXPENSE. NOTE: DELIVERIES TO PO BOXES MUST BE PICKED UP WITHIN SEVEN DAYS OR THEY WILL BE RETURNED TO THE WSO. RETURN SHIPPING WILL BE AT CUSTOMER'S EXPENSE. THANK YOU FOR YOUR COOPERATION. ALL PRICES ARE SUBJECT TO CHANGE WITHOUT NOTICE If ordering for a group, area, region, treatment or correctional facility, please indicate. Indiv./Grp. Area Region Organization NAME 7/03

7 WSO ORDER FORM TO BE USED IN SOUTH PACIFIC AND ASIA WSO, PO BOX 9999, VAN NUYS, CA USA Tel Fax Website DESCRIPTION LANGUAGE ITEM QUANTITY UNIT PRICE TOTAL

8 Mail order to: World Service Office PO BOX 9999 Van Nuys, CA USA Tel. (818) Fax (818) Single Purchase Discounts $.01 $ = 0% $ $ = 23.5% $ $ = 25% $1, or more = 27% Shipping Schedule For orders less than $500 add 10% For orders more than $500 charges will be billed. MAKE CHECKS PAYABLE TO NAWS, INC. All purchases must be made by Cashier's Check or Money Order drawn in US currency. TOTAL PRICE OF ORDER Subtract Discounts Add Shipping and Handling Fee 14-K Gold Medallion Shipping/Insurance Fee $10.00/Medallion Shipped separately via Federal Express, insured for $ For international shipments, please call the WSO for shipping costs. ORDER TOTAL CREDIT CARD PURCHASE: PLEASE PRINT ALL INFORMATION. YOU MAY FAX YOUR CREDIT CARD ORDER. VISA AMERICAN EXPRESS MASTER CARD DISCOVER CARD DINERS CLUB CREDIT CARD NUMBER EXPIRATION DATE LAST NAME OF CREDIT CARD HOLDER FIRST NAME SIGNATURE DATE Bill to: PLEASE PRINT ALL INFORMATION. DO NOT ABBREVIATE STREETS OR CITIES. Ship to: PLEASE PRINT ALL INFORMATION. DO NOT ABBREVIATE STREETS OR CITIES. CUSTOMER ID (found in the upper right corner of invoice) NOTE: SHIPMENT BY DHL OR FEDERAL EXPRESS IS AT CUSTOMER'S EXPENSE. NOTE: DELIVERIES TO PO BOXES MUST BE PICKED UP WITHIN SEVEN DAYS OR THEY WILL BE RETURNED TO THE WSO. RETURN SHIPPING WILL BE AT CUSTOMER'S EXPENSE. THANK YOU FOR YOUR COOPERATION. ALL PRICES ARE SUBJECT TO CHANGE WITHOUT NOTICE If ordering for a group, area, region, treatment or correctional facility, please indicate. Indiv./Grp. Area Region Organization NAME 7/03