Fax order form
Please print this form, fill out the details, and fax it +1 208-523-9482
B I L L I N G |
S H I P P I N G |
| Company: | Company: |
| Address: | Address: |
| Address: | Address: |
| City: | City: |
| State: | State: |
| ZIP/Postal code: | ZIP/Postal code: |
| Country: | Country: |
| Attention: | Attention: |
| Phone: | Phone: |
| Fax: | Fax: |
| Email: | Email: |
Qty |
Product |
Available Platforms |
Comm
|
Edu/Gov
|
Total Cost |
| RPM Remote Print Manager® Elite | Windows 2000-2008/XP/Vista/Windows 7 | $648.00 | $388.80 | ||
| RPM Remote Print Manager® Select | Windows 2000-2008/XP/Vista/Windows 7 | $324.00 | $194.40 | ||
| ExcelliPrint Premium® (includes 1 printer) | Windows 2000-2008/XP/Vista/Windows 7 | $795.00 | $477.00 | ||
| Additional printers | $395.00 | $225.00 | |||
| ExcelliPrint Standard® (includes 1 printer) | Windows 2000-2008/XP/Vista/Windows 7 | $495.00 | $297.00 | ||
| Additional printers | $325.00 | $195.00 | |||
| INTELLIscribe® | Windows 2000-2008/XP/Vista | $295.00 | $177.00 | ||
Shipping and Handling Charges (please check one) |
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| NO CHARGE for electronic delivery (software has been or will be downloaded) | |||||
| $5.00 per CD-ROM + Shipping costs (you will be charged for shipping) (note that CD contains 21 day trials for RPM, INTELLIscribe & ExcelliPrint and online support materials) |
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(please check one) Educational____ Government____ Commercial____ Non-profit____ TOTAL: |
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Payment Information / Details |
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| Purchase Order number: (Please FAX Signed PO along with this form) | |
| Check number: | Amount: |
| Credit Card: (please circle) MasterCard Visa American Express | |
| Account number: | Expiration Date: |
| Name on card: | Signature: |
| NOTES:
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