Mouse Pad Order Form Mark-ID Sales Promotion Specialists Please print out and complete the following form. Fax to 209/315-7108 or mail to: 13223-1 Black Mountain Road #346, San Diego, CA 92129

(PLEASE PRINT YOUR NAME) Ordered By: ______________________________________________ Business NAME: ___________________________________________ Street No. _______________________________________________ Suite/Unit No. ___________________________________________ CITY _________________________ State _____ Zip ___________ TEL: _____________ Fax: _____________ Email: _____________ Size: ________________________________________________ Quantity: ____________________________________________ Shape: _______________________________________________ Backing: ___Non-slip foam or ___Rubber Other:_________________________________________________ Signature X__________________________Date: ____________ Special Instructions: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________

All orders are subject to 5 % over or under run.

In the future, MARK-ID will be sending price list updates, as well as other promotional information by e-mail/fax to customers whom authorize us to do so. If you wish to receive fax/e-mail from us, please fill-in the authorization form below.

AUTHORIZATION FORM

I AUTHORIZE MARK-ID TO FAX OR E-MAIL COMPANY'S SALES ANNOUNCEMENTS, PRICE LIST UPDATES AND OTHER PROMOTIONAL INFORMATION

COMPANY NAME: ___________________________________ FAX#: __________________

AUTHORIZE NAME: _________________________________ E-MAIL: ________________

SIGNATURE: ______________________________________ DATE: __________________

Thank you!