Sample: Order Form

Product Order Form

ABC Software Company

Please complete this form. Some one in our sale department will contact you shortly.

Thank you for your business.

Note: Marked with * are required.

Section 1

1.1

Select the product(s) you like to order:

Product 1 ($100)	Product 2 ($50)
Product 3 ($1000)	Product 4 ($20000)
Product 5 (free)

1.2

Additional Information

1.3

How would you like to pay?

The check is in the mail	I will send our purchase order
Contact me

Section 2

2.1

Please complete your contact information

Your Name:	*
Title:	*
Company:	*
Street:
City:	*
State/Province:	*
Zip/Post code:
Country:	*

2.2

Would you like to receive a free newsletter? *

Yes, please

No, thanks

2.3

How would you prefer to be contacted?

By Mail	By Fax
By Email	By Phone
Please don't contact me

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