SysCon Technology On-Line Order Input Form
Is this an Order or a Request for Quote?

Ordered By

Name
Phone
FAX
Email

Purchase Order Number

Shipping Address Information

Name, company, address, zip 		We compare this address to the USPS street address list for validity in order to direct ship from the warehouses. Please note in shipping instructions if this address is an exception and is not used for mail delivery.

Products Being Ordered:
Quantity Brand Part No/Description Unit Price

Special Instructions

 If you need more line items on your order, add them in "Special Instructions" or make a note in "Special Instructions" and create another order for the additional items (you only need to provide minimal information so we can match the common data on the second order with the first order.)

Shipping Method

UPS Ground is normal method.
Post Office is not available for orders direct from warehouse.
If you have special shipping instructions, include them in "Special Instructions" above.

Other Charges

Select your sales tax code at left.   $6.00 Small Order Charge, under $600
or $8.00 Small Order Charge, under $50
Order Policies
Shipping Cost Estimate

Credit Card and Billing Information
Use credit card info from last order.

We will accept PO's from California Companies with a Credit Application on file.

Billing Name and Address on Credit Card

We match this address when
processing credit card payments.

Select the print button on your browser to print a copy of the order, then press the "submit order" button.

An invoice will be faxed to the person sending in the order or mailed to the billing address.

or you can clear the form

SysCon Technology, Inc.
31500 Grape St #3-289, Lake Elsinore, CA 92532		 E-mail: sales
@syscontech.com
(951)674-5081 or FAX: (877) 683-1721