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HotClock Order Form

Mail: Code Workshop       302 9th Avenue       Haddon Heights, NJ 08035-1832       USA FAX: 856-546-6929HotClock is $49.95 plus $5.00 shipping/handling for each copy

     ______ copies of HotClock @ $54.95 each = ______      New Jersey residents add 6% sales tax     ______      Total Payment                             ______Shipping Information

     Name:    ____________________________________________      Company: ____________________________________________      Address: ____________________________________________      City: _______________________ State/Prov: ___________      Zip/Postal Code: ____________ Country: ______________      Email: ______________________________________________Payment Method

     [ ] MasterCard      [ ] Visa      [ ] American Express      [ ] Discover      [ ] Check/Money Order/Cash (payable in US dollars)      [ ] Purchase Order (enclosed)Billing Information (if using a credit card)

     Credit Card Number: ________________________________      Expiration Date: ___________________________________      Signature: _________________________________________      Name on Card: ______________________________________      Company: ___________________________________________      Billing Address: ___________________________________      City: ______________________ State/Prov: ___________      Zip/Postal Code: ___________ Country: ______________