PLACE AN ORDER - On Line Please use this form to place your order via the Internet. BILL TO Mandatory fields *    Name of Organization  *  Business Identification No *  Promotion Code  Attention of * Street * City *  State State Alabama Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Flordia Georgia Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Telephone * Fax E-Mail     SHIP TO Same as above Name of Organization  Attention of Street City   State  State Alabama Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Flordia Georgia Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code Telephone Fax E-Mail Method of Payment* Cheque  Visa   or  P.O.# **If you select Visa, a representative will contact you to obtain proper authorization***          ** Please make checks payable to Sound Listening Environments Inc.** Order  Quantity To Outfit Price Units Ordered Total Price   6 + Classroom Sets* *  $209 per set     3 - 5 Classroom Sets* * $219 per set   1 - 2 Classroom Sets* 30 - 60 chairs $229 per set * Each Classroom set contains (10 doz.) to outfit 30 chairs        Sub Total       *15% Shipping       Total * Orders will be shipped via surface/ground.                      Warranty A warranty of two (2) years applies from date of purchase under conditions of normal use