Brooks Internet Software Fax Order Form - International

Please print this form, fill out the details, and fax it 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:


Available Platforms


Total Cost 
  RPM Remote Print Manager™ Elite Windows 2000/NT/XP/2003 $598.00 $498.00  
  RPM Remote Print Manager™ Select Windows 2000/NT/XP/2003/Vista $298.00 $194.40  
  ExcelliPrint Premium Number of devices:____ Windows 2000/XP/2003/Vista $795.00

(per device)

(per device)
  ExcelliPrint Standard Number of devices:____ Windows 2000/XP/2003/Vista $495.00

(per device)

(per device)
  INTELLIscribe Windows 2000/XP/2003/Vista $295.00 $177.00  
Shipping and Handling Charges (please check one)
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 (RPM, INTELLIscribe & ExcelliPrint) and online support materials)

(please check one)     Educational____     Government____       Commercial____       Non-profit____           TOTAL:



Payment Information / Details
Credit Card:  (please circle)      MasterCard     Visa     American Express
Account number: Expiration Date:
Name on card: Signature: