Order Form

citybizlist.com

Order Form Print Invoice

Orders can be placed online or via this form. Please contact us if you have any questions.

citybizlist.com c/o Beyond.com, Inc. 1060 First Avenue Suite 100 King of Prussia, PA 19406	Order: ORD-1614900-29 Date: 2/9/2010 10:19:56 AM Email: Invoice@Beyond.com Phone: (866) 694-JOBS Fax: (610) 878-2801 Payment Type: ___ Check ___ Credit Card
Contact Information: Name: _______________________________ Company: ____________________________ Address: _____________________________ ____________________________________ Phone: ______________________________ Fax Number: ________________________ Email: ______________________________	Credit Card Information: (required if paying via credit card) Name On Card: ______________________ Card Type: ______________________ Card Number: _______________________ Expiration Date: ___ / ___ Verification code: _______ Billing Address: _____________________________ ____________________________________

Fax us this page to complete your order

Please select the products that best fit your needs below. If you need any assistance or would like to make other payment arrangements, please feel free to contact our account managers by calling toll-free at (866) 694-JOBS.

	Title	Description	Total Price
	5 Job Postings	Receive 5 Job postings, with apply URLs which can be used anytime for up to one year. Each job will remain active for 60 days.	$950.00

AMOUNT DUE:

Make checks payable to:
Beyond.com, Inc.
Tax ID: 23-2773769

Comments:

Instructions: Please review, sign, and fax to (610) 878-2801.

Authorized Signature The client company identified above ("Client"), by their authorized representative, has executed this Agreement as of the date(s) set forth, the latter of which shall be the effective date of this Agreement ("Effective Date"). This Agreement and the corresponding Terms and Conditions, available a http://www.beyond.com/psaterms.htm herein by reference, shall be binding when signed below and delivered to the Beyond.com (which delivery may be accomplished by facsimile transmission).

Name: ____________________________________________
Signature: _________________________________________ EffectiveDate: ____________

Your service will not be activated until payment is received, or invoice has been approved for initiation.