MOUSEPAD.COM 
                              The Mousepad Company 
                              Mousepad Order Form 
                              Phone: 800.MOUSEPAD 
                              Fax: 626.385.6200 | 
 Attn: | 
 Quote Department | 
| Date: | 
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| Any Controversy or claim arising out of or relating
          to this contract or the breach thereof shall be settled by the arbitration in accordance
          with the Uniform Rules for Better Business Bureau Arbitration, and the judgment upon the
          award rendered by the Arbitration(s) may be entered in any court having jurisdiction
          thereof. | 
| Mousepad Specifications | 
| Mousepad Type: | 
Full Color Hard Plastic Top | 
| Size: | 
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| Thickness: | 
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| Quantity: | 
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| Colors: | 
Full | 
| Rush: | 
 
          Ideal Delivery Date : 
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| Where do You Want these Mousepad Shipped? | 
| Company Name: | 
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| Attn To: | 
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| Address: | 
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| City, State, Zip, Country | 
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| Phone:  | 
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| Fax: | 
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| Email: | 
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| How Would you Like to Pay for These Mousepad? | 
| Payment Method: | 
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| Credit Card Number: | 
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| Expiration:  | 
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| Cardholder's Name: | 
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| Billing Address: | 
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| City, State, Zip, Country | 
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NO C.O.D. - Orders will not be processed without a Signature of Authorization 
Authorization (Please Fill Out This Part Completely)
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| TERMS | 
Payment: Please allow 2-3 weeks for normal delivery. Rush orders please contact us. We will process your order with 50% payment via bank transfer. The balance will be due before shipping. We will fax you the tracking/airway bill number. Entire balance has to be paid upon Shipping.  Credit card payments will incur a 2.7% charge over the total amount of the invoice. 
 
If you have any questions, please don’t hesitate to call us at (626) 796-3100, and let us know how we can help you.
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| Name (Please Print): | 
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| Signature: | 
 Check This Box to Confirm That you have reviewed our terms in regards to payments, and that all the info you have provided are correct, and would like to Place an Order with Mousepad.Com.  The Checked Box will be your Signature of Authorization. | 
| Notes | 
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