H O S T A R

    

EZ Edger Order Form
       
       

Date :
 

Telephone :
 

Contact :
 

Fax Number :
 

Company :
 

Address :
 
 
 
 
 
   

Your Reference Number :

 
       

Order Quantity

 

@   $62 + $ 11 (S/H) Each  =   Total $
 
       

Credit Card Type :

 

Exp. Date :

               /
       

Name on the Card :

 

CVV2 Code :

  
       

Credit Card Number :

 
       

Signature :

 
       
  * I agree to pay the above amount according to the card issuer agreement.
       

Fax the completed form to 770-447-6963.   For outside of continental U.S. shipment, please contact us for a correct shipping charge.  If you have questions, call us at 770-441-0480.  For purchase with a check, please mail the complete form with a check to : Hostar, Inc.  3760 Grand Forest Dr.  Norcross, GA  30092