Celerity Works - to order by fax or mail-in -- please print this form

PLEASE FAX THIS FORM TO: 206.780.4203

or send by mail with your payment to:

Celerity Works
120 Wood Avenue SW
Bainbridge Island, WA 98110

Please Check Your Selection Below

___ Order Option 1 $49 - Includes printed hard copy version *

___ Order Option 2 $29 - Includes PDF instant download version.

___ Order Option 3 $59 - Includes BOTH PDF instant download and printed hard copy versions. *

* Plus $8.95 shipping and handling.

CUSTOMER INFORMATION (NOTE: CALL 206.780.4202 IF YOU HAVE ANY QUESTIONS)

First name: ________________ Last name: ____________________________________

Title: _____________________ Organization: ___________________________________

Address: _________________________________

City: _____________________________________ State: _________ Zip code: _____________

Phone: __________________________________ E-mail: _____________________________________

PAYMENT INFORMATION

___ Credit Card (VISA or Mastercard only): Name on card: ____________________________________________

Card number: ___________________________________ Expiration Month: _____ Year: ___________

Signature: _____________________________________ Date: ________________________________

___ I'll mail a check payable to Celerity Works within 5 business days to:

Celerity Works - 120 Wood Ave. SW, Bainbridge Island, WA 98110

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For further information, please email contact@celerityworks.com or call: 206-780-4202 (PST)