ZIPFOCUS

 

Helping Houston Area Businesses find Quality Customers

 

       
       

                               Demographic Report Order Form

 Date: ___________________

Report Product

Total

 

Regional zip code reports (specify region reports desired)

  $99.95 each

 

 

 

 

 

 

 

Individual Zip Code Reports (specify individual reports desired)

  $9.95 each

 

 

 

 

 

 

 

 

 

 

Total Order Price (includes all taxes, shipping and handling):

 
 
Specify Desired Report Format - Adobe Acrobat (.pdf) or Microsoft Word (.doc):   
Customer Contact Information
 Company Name:  
 Contact Name:  
 Mailing Address:  
   
 Phone Number:  
 Email Address:  
Order Instructions
1)  Fill out this form, and calculate the total amount.
2)  Mail completed form and check to: ZipFocus.com
Attn:  Dave Wallis
14718 Kings Head Drive
Houston, TX  77044
Your order will either be emailed to you, or shipped via 2-day priority mail within 3 business days.  If you have any questions about your order, please email info@zipfocus.com.  Thank you!