The PC Users Group

Modem order form


Please note:
Please fill out the information below. Once you have completed it, select Submit at the bottom of this page. To blank all details, select Cancel.
Model required     
Software/cables    

Delivery ($10.00) (give instructions below)

M'ship No. Last Name First Name Home Phone Work Phone Fax Email

Credit card

Card name Card number Card expiry

Please type any other comments or instructions below:

Note: Please allow at least two weeks for delivery (where delivery is required). If you do not request delivery, you will need to pick your order up from Maestro yourself.


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