Privateer Press Demo Program Order Form Privateer Press, Inc. 1705 136 Place NE STE 120 Bellevue, WA 98005 Phone: (425) 643 643-5900 Fax: (425) 643-5902 website: www.privateerpress.com Ordering information and instructions: Orders are limited to brick-and-mortar mortar retail stores. Stores are limited to one copy of each available product on this list. We accept checks, money orders, Visa, MasterCard, American Express, and Discover. For credit cred card orders, please fax completed form to (425) 643-5902 5902 or email the completed form to [email protected] Price does NOT include shipping. Payment is due before order ships. Shipping will be added at the time of order. If you have any questions, uestions, please contact [email protected]. SHIPPING INFORMATION Order date:___________________ Store name:________________________________________ _______________________ Contact name:________________________ ________________________ Street:____________________________________________ Country:_______________________ City:_____________________________ State/Province:____________ ZIP/Postal code:_____________ Telephone:_______________________ Email:_______________________________________ ORDER INFORMATION: Check your Selection PIP 61002 61003 61020 62001 62007 60003 60004 60005 60007 60008 417 61019 N/A Item WARMACHINE High Command Core Set HORDES High Command Core Set WARMACHINE High Command Faith & Fortune Core Set LEVEL 7 [ESCAPE] LEVEL 7 [INVASION] Scrappers Heap Infernal Contraption, 2nd Edition BodgerMania Zombies Keep Out Iron Kingdoms Unleashed Adventure Kit The Undercity All of the Above MSRP $44.99 $44.99 $44.99 $54.99 $89.99 $24.99 $21.99 $21.99 $21.99 $35.99 $44.99 $94.99 $546.88 $54 Price* $10.00 $10.00 $10.00 $12.00 $20.00 $4.00 $4.00 $4.00 $4.00 $10.00 $13.00 $20.00 $121.00 *Price does NOT include shipping. Shipping will be added at the time of order. Order total: $____________________________ ________________________ PAYMENT INFORMATION If paying by check or money order, please mail completed form with payment to the address above. If paying by credit card, please enter the following information and fax completed form to the number listed ab above. ove. Name on card:_______________________________________________________________________________ Billing address:_______________________________________________________________________________ City:_____________________________ State:____________________________ ZIP code:____________ Card number:_______________________________________ _______________________________ ____ Expiration date:_____________________ 3-digit CVV code:__________________ Cardholder's signature:_____________________________________ ©2001–2017 Privateer Press, In Inc. c. Trademarks are property of their respective owners.
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