Customer Order Form
First Name:
Last Name:
Phone:
Customize Your System:
Processor speed:
1.5 GHz
1.9 GHz
2.5 GHz
3.2 GHz
Memory:
64 MB
128 MB
256 MB
512 MB
Drive size:
15 GB
30 GB
60 GB
Monitor size:
15-inch
17-inch
19-inch
21-inch
CD-ROM:
24x
32x
48x
64x
72x
Credit Card Information:
Credit Card (select one):
American Express
Discover Card
MasterCard
Visa
Name on card:
Card Number:
Expiration date:
01
02
03
04
05
06
07
08
09
10
11
12
2004
2005
2006
2007
2008
2009
2010
Yes, I would like to be put on Millenium Computers mailing list.
Millenium Computers Inc. • 4297 East Old Wire Road • Toomsuba, MS 39364 • 1 (800) 632-4851
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Contact the creator of this form at
tuandelia2@aol.com