|
| Order Information |
| Name: |
___________________________ |
Company: |
__________________________ |
| Street Address: |
___________________________ |
Shipping Address: |
__________________________ |
| City: |
___________________________ |
State/Province: |
__________________________ |
| Zip Code: |
___________________________ |
Country: |
__________________________ |
| Phone Number: |
___________________________ |
FAX Number: |
__________________________ |
| E-Mail: |
___________________________ |
Web Address: |
__________________________ |
| Profession: |
___________________________ |
Browser Used: |
__________________________ |
|
| How Did You Hear About The Product? |
| Name: ____________________________________ (Examples: ZDNet, FileMine, etc.) |
|
| System Information |
| Operating System:___WindowsCE___Windows98___Windows2000___WindowsXP |
|
| Shipping Method (Estimate) |
| ____$10.00 UPS Ground (continental USA) |
____$45.00 Canada/Mexico/South America |
| ____$25.00 UPS Air (continental USA) |
____$55.00 Europe |
| ____$30.00 Alaska, Hawaii, & Puerto Rico |
____$75.00 Africa, Asia, Australia |
|
| Purchase Information All orders are downloads unless othewise noted. |
| DataCom2000 |
____@ $89.95 |
$_______ |
WorldTime |
____@ $29.95 |
$_______ |
| DataCom2000 Network |
____@ $159.95 |
$_______ |
Real Estate |
____@ $29.95 |
$_______ |
| PIM Pro |
____@ $59.95 |
$_______ |
ADA Software |
____@ $39.95 |
$_______ |
| FaxWizard |
____@ $49.95 |
$_______ |
ADA/CA Software |
____@ $59.95 |
$_______ |
| MultiWeb Viewer |
____@ $19.95 |
$_______ |
ADA/CA Manual |
____@ $59.95 |
$_______ |
| |
|
|
ADA/CA Checklist |
____@ $99.95 |
$_______ |
|
| Payment Method CD Key:______________-______________-_______________ (if applicable) |
|
Subtotal |
$_______ |
Credit Card: MC VISA Am Express |
| (California: add 7.50% tax) |
Sales Tax |
$_______ |
Cardholder:________________________(Print) |
| (Refer to shipping method) |
Ship & Handling |
$_______ |
Card #:____________________ Exp:______ |
|
Total Payment |
$_______ |
Signature:_____________________________ |
| Your signature verifies you have read and agree to the license agreement and export agreement. |
| Fax this completed order form to: (858) 484-9134. |