Fax Order Form

Instructions:

Method 1: Manual Fax
  • Fill out the form in your browser
  • Print the page from your browser program
  • Feed it manually through a fax machine
  • Fax Orders to Attention:
    "Don Sampson"
    1 - 705 - 567 - 4364

    Method 2: Fax Modem
  • Fill out the form in your browser
  • Disconnect from the Internet
  • Print the form to your Fax Modem
  • OR
  • Save this page as a HTML file
  • Open it in your browser off-line later
  • Fill out the form in your browser
  • Print the form to your Fax Modem
  • First Name:
    Last Name:
    Street Address:
    Apt.#:
    City:
    Province/State:
    Country:
    Postal/ZIP Code:
    Phone Number:
    (Include your area code!)
    Quantity:

    Thank you for ordering Don's Heater Plans/Challenger Mods
    We will call you to verify your order and credit information.

    Daring Don's Ultimate Flying Machine
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