• call BridgePad Company Sales at 650.520.6210
OR
• Print out this order form, fill it in and
  • FAX   to (650)964.2426
  OR
  • MAIL   to:
    
    BridgePad Company
    465 Fairchild Drive, Suite 103
    Mountain View, CA 94043

BridgePAD™ Order Form

Billing Information

Name On Credit Card:
Address:
City :
State:
ZIP:
Card Type	Visa              Mastercard                Discover           American Express
Card Number
Expire Date:
Email Address:
Phone #:

Shipping Information

( check box if Shipping information is same as Billing information)

Name:
Address:
City :
State:
ZIP:
Email Address:
Phone #:

Products

Item	Price	ExtdWty	Quantity	*Shipping	Cost
BridgePad™ terminal 1-19 units	$125	$10
BridgePad™ terminal 20 or more units	$120	$10
BridgePad™ Base Unit	$125	$10
Carry case for BridgePad™ TableTop Terminals	$75
TOTAL COST