Fax Your MFIII/ Blue Cell Order Now!

 

OneRom Group, Inc.

To order MFIII/ Blue Cell  by fax, please follow these simple steps:

1. Type in all the information below (* indicates a required field).

2. Print this order form. 

3. Fax this page to (212)591-6810. 

4. Send us an email indicating you have ordered MFIII/ Blue Cell by fax (important step, please do not forget).

That's it! As soon as we receive your fax order, we will send you a confirmation email and proceed your order immediately. Thank you for your support!
 

*Name:


*Billing Address 

(This must be the same  as the 

billing address on your credit card.)

*Street Address:




*City:



*State/ Province:



*Zip Code:



*Country:


Shipping Address

(Fill in this only if it is different from the billing address.)


Street Address:





City:



State:



Zip Code:



Country:


Contact Information


Telephone:



Fax:



*Email Address:


Unit Price for MFIII/ Blue Cell

Order one box of MFIII for only $159.95,

Order one box of Blue Cell for only $219.95.

plus shipping and handling: 

U.S. $10.00, 

International $20.00.

*Quantity (Number of MFIII/ Blue Cell):        

Credit Card Information


*Name of Credit Card Owner:



*Credit Card Type:



*Credit Card Number:



*Expiration Date: