Blue Bell Design  

Controller, PCB, & Co-Processor Chip Order Form
Customer Information

  Name

  Address

  City

  State

  Zip Code

  Phone

  E-Mail

Order Instructions

Please choose desired product quantities and prices from the list below. Use the extra lines for products not already listed on the form. Add Sales tax if appropriate. Total the order in the space provided.

Product Order

Product

Each

Qty

Total Price

  Bare Co-Processor PCB

$14.95

  Bare PCB Shipping (each)

$7.00

  Co-Processor Add-on Kit

$64.95

  Co-Processor Kit Shipping (each)

$10.00

  Robot Co-Processor Chip

$39.95

  Co-Proc Chip Shipping

$7.00

6% Sales Tax
(PA only)

Total

Send this form with a check or money order to -

   Blue Bell Design Inc.
   Please email harry <at sign> bluebelldesign.com for the address


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