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Chicago Title Western Region Appointment Book Online Order Form

* Indicates a required field

Company Name: *

Contact Name: *

Phone Number: *

Fax: *

Email Address: *

Do you have Multiple Shipping Addresses? *

Yes
No

(If you select "Yes," please enter your primary Shipping Address below and we will contact you and get the additional shipping addresses.)

Shipping Address: *

Shipping City: *

Shipping State: *

Shipping Zip Code: *

Billing Address: *

Billing City: *

Billing State: *

Billing Zip Code: *

One billing address allowed per order. If you have multiple billing addresses please fill out a separate order for each billing address.

Pricing:

The Chicago Western Region group price is only $5.10

Minimum Quantity is 500

Black Flexible Leatherette cover is included in above price

***NOTE*** Hardcover is available for $0.32/ea additional charge

**ACT NOW** Special Western pricing applies to orders received by April 6, 2012!

Quantity of Appointment Books:

Indicate your quantity below.

Orders must be in multiples of 20 due to carton size.

If the quantity you have indicated is not evenly divisible by 20 we will round up your quantity to the next even amount.

Quantity *

Order Type: *

Add Cover Material: *

Your Sales Representative: *

Delivery:
Please select when you would like to receive your order below.

Requested month of arrival / suggested order timeline: *

November / order finalized by Sept. 1st.*
October / order finalized by Aug. 1st*
August / order finalized by June 1st.*
No preference / order to arrive by mid December.

*NOTE: This does not guarantee delivery arrival due to space availability and/or possible transit delays. Every attempt will be made to fulfill this request.
Order is not considered final till submitted and proof (if sent) is approved.
Questions? Please call.

Orders placed after October 1st may be subjected to additional upcharges.

Special Instructions:

Upon receipt of your order, a Dataguide representative will contact you with instructions on how to submit copy for your customized intro pages. Proofs will be sent for your approval, once copy is received.

If you have any questions, please don’t hesitate to call your sales representative.

Brad Burdick: 916-817-8700 / Email: bburdick@dataguide.com

Rob Higgins: 925-254-8114 / Email: rhiggins@dataguide.com

Cust. Svc: 800-343-0583 / Email: sales@dataguide.com