order form
    "The DockMaster"
           Order Form

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___________________________________________________________________

Ship to:
Organization ____________________________________________________________                                                                                        
Name            ____________________________________________________________                                                                                       
Address        ____________________________________________________________
                     ____________________________________________________________                                                                                     
                     ____________________________________________________________                                                                                   
Phone           ____________________________________________________________                                                                               
Cell Phone   ____________________________________________________________
Email           ____________________________________________________________

Cost (US dollars -includes all taxes, shipping and handling):

____Basic Program $4500 ( tailored to your dry dock)
____Pumping Plan Version $5000 (tailored to your floating dry dock)

Payment:
___ Check. Make checks payable to DM Consulting.
___ Credit card.    Visa      Mastercard       AMEX  (circle one)   

    Card number          ______________________________________________________
    Expiration date       ______________________________________________________
    Card holder name   ______________________________________________________
    Card holder address______________________________________________________
                                  ______________________________________________________
                                  ______________________________________________________
                                  ______________________________________________________
    Card holder phone ______________________________________________________
    Card holder fax      ______________________________________________________

 

Return form to DM Consulting:
Fax: +1-858-538-5372
Mail: 12316 Dormouse Rd
          San Diego, CA 92129
          United States
Email: jstiglich@aol.com

For more information visit www.drydocktraining.com or call +1-858-705-0760.
Program ships in 4-6 weeks after receipt of payment.