Rosters of the Confederate Soldiers of Georgia

Rosters of the Confederate Soldiers of Georgia Order Form
CD-ROM $89.95.

Use this form if ordering via FAX.
Fill in the blanks below, then print the form, and fax to (706) 792-9905.
Credit Cards, electronic checks and COD are welcome.

We appreciate hearing where you heard about our products

Name:

Address:

City:

State/Province:

Country:

Zip Code:

Email Address:

Phone #:

Enter the following information to pay via Electronic Check.

The name and address of your bank

Your name and address

The routing information along the bottom of your check

Your checking account number

We'll process your order immediately and issue a bank draft for the amount of your order AFTER we ship. It's that simple.

Name of your bank:

Your Bank's Address:

City:

State:

Zip Code:

Bank Routing Numbers: (the 9 digit routing numbers printed in OCR font along the bottom edge of your check).

Your Account Number:

Check Number to Use:

Enter the following information to pay via Credit Card.

The name of your card

Your name as it appears on the card

Your card number

The date of expiration

We'll process your order immediately and charge your card for the amount of your order AFTER we ship. It's that simple.

Name of your card:

Your Name as it appears on the card:

Card Number:

Expiration Date:

FAX this form to (706) 792-9905
Orders may also be sent via U.S. Snail to: Eastern Digital Resources
5705 Sullivan Point Drive
Powder Springs, GA 30127

Phone: (706) 312-0870
Fax: (706) 792-9905