STAR ADVERTISING ORDER FORM

(1) Fill out and fax this order form to (425) 908-7935

or (2) Call Star Advertising directly at (425) 908-7934

or (3) Fill out and mail this order form to: Star Advertising,

2030 Castle Drive, Bothell, Wa. 98021

Name__________________________________________

Customer # if you have one________________________

Company_______________________________________

Address________________________________________

City__________________ State_______ZIP___________

Country________________________________________

E-Mail Address__________________________________

Phone (______)_______-______________

Fax (______)_______-________________

PO#_____________ORDER DATE______________ DATE NEEDED, If critical________________

ITEM DESCRIPTION (Include shape, color(s), size etc.) QTY PRICE EACH TOTAL

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Ship via: ground__ 3rd day__ 2nd day__ next day __

PAYMENT METHOD:

Check/Money order___ COD ___Visa ___MasterCard ___Discover ____

Name on Card________________________ Card Number_______________________Exp Date_______

Fill Out And Fax Back To: (425) 908-7935