On-line Order Form

Data Direct is pleased to offer the convienence of online ordering. Should you have any questions or require a Data Direct representative to assist you, please call us at 800-870-DATA (3282). Assuming this order form is completed correctly, Data Direct will have all of the required information to service your request. This completed form will be considered your authorization to begin the sales transaction and if applicable, charge your credit card for products requested and shipping/handling costs. Orders are processed at Data Direct Monday – Friday: 8:30am – 5:15pm EST. Thank you for allowing DATA DIRECT to service your business.

Red Text Denotes required items:

Order Classification:	Place reorder by current customer with Customer ID# Place new order by current customer with Customer ID# Place new order by new customer Request for Quotation or Information
Payment Method:	Visa MasterCard American Express C.O.D. (United States Only) PO with prior credit application submitted PO with new credit application submitted Wire Transfer Payment Terms must be arranged; please contact me
Purchase Order
Credit Card Information:	Credit Card Number
	Expiration Date
	Name on Credit Card
	Billing Address of Credit Card
Customer Information
Company Name:
Customer ID#:
Contact:
Title:
Address:
City:
State:	Zip +4
Country:
Email:
Telephone:
Fax:
Products by Type for Purchase:
Shipping Information: Note: Data Direct will add shipping & handling costs to your order.
Type of Shipping Service Requested:	Ground Next Day 2 Day 3 Day Best Way
Carrier/Shipping Requested:	UPS FedEx DHL Airborne Courier Data Direct
Requested Form of Shipment Confirmation:	Fax Telephone Email Not Necessary
Ship to Address: Leave Blank if same as company address.	Company:
	Attn:
	PO#:
	Address:
	City:
	State:	Zip Code: + 4:

Upon completion of this OnLine order form, please click "Send Order" . Your order will be processed and your credit card will be charged. In addition, it is important to provide Data Direct with a telephone number should we require additional information to complete your order. The submission of this order gives Data Direct the authority to charge your credit card for products ordered and shipping/handling costs. Should you have specific questions regarding pricing, product availability or specifications, we available at 800-870-DATA (3282). Thanks again for allowing DATA DIRECT to service your business.

Distributor of CD copiers, DVD-R duplicators, CD-R printers, DVD towers, DVD publishing systems, CD and DVD media, jewel cases, inkjet cartridges, Everest and Prism thermal ribbons; from the most trusted names in the industry: Rimage, Primera Technology, Microboards, Taiyo Yuden, Mitsui, SKC, Sony, Pioneer.

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All products subject to availability and change without notice.