Purchase Order Form

This form may be used for several different purposes: 1. To purchase Hannaian Product. 2. To register and / or pay for Hannaian Business Training Institute Conferences, Seminars & Retreats. 3. To facilitate any other Hannaian online payment, or registration process otherwise identified in the Website. Please fill out the form below and fax or mail it in with payment information if you prefer. The fax method of ordering will delay receipt of your ordered items by approximately one week.

Please identify which type of transaction you are using this form for at this time:

Transaction Type

Note: Publisher I.A.N. Code is only applicable to Hannaian Publishers

IAN Code:

First Name:

Last Name:

Middle Initial:

Email Address:

Internet Address:

Street Address:

City:

State:

Zip Code:

Country:

Country Code:

Telephone:

Fax Number:

Male
Female

Referring Publisher Name:

Item Stock Number:

Item Description:

Amount of Items:

Item Price in U.S. currency

Price US Dollars:

Shipping + Handling (Total + 10% U.S. orders, or + 15% Non-U.S. orders. **Minimum $3.00 must be included)

Shipping Costs:

Total Order (Shipping + Handling)

Total Order:

Payment Type

Credit Card Number:

Expire Date:

How did you hear about us:

Internet
Friend
Publication
Radio
TV
Postal Mail
E-Mail
Publisher
Other
Multiple items may be chosen.

Explain Further? (Optional)

Explain Further:

Questions/Comments? (Optional)

Questions/Comments:

FOR CUSTOMERS LOCATED OUTSIDE THE UNITED STATES: If outside the United States this order will be submitted to Hannaian International Ltd. Also this order form may be printed, mailed or faxed t o Hannaian International at (242) 364-1980 if you prefer.

FOR CUSTOMERS LOCATED WITHIN THE UNITED STATES: If within the United States this order will be submitted to Hannaian U.S.A. Corp. Also this order form may be printed, mailed or faxed to Hannaian U.S.A. at (561) 842-5006 if you prefer.

Outside The United States
Inside The United States