WinPatch(TM) 1.2.6 Registration Form/Invoice Ordering by check: To order by check send this order form and a check to Artistry, Inc., PO Box 115, Blue Bell, PA 19422. Payments must be in US dollars drawn on a US bank, or you can send international postal money orders in US dollars. Credit card ordering: For information on ordering by MasterCard, Visa, American Express, or Discover by phone, FAX, email, or postal mail, see the section titled Credit Card Ordering on the next page of this form. Purchase Orders: For information on using purchase orders see the section titled Purchase Orders on the next page of this form. Site licenses: A site license for WinPatch entitles an organization to receive one copy of the distribution package and duplicate the distribution disk for the specified number of copies. Prices guaranteed through December, 1999. WinPatch Single Copy ____ copies at $50 each = ______ WinPatch Site License 2 to 9 computers: ____ computers at $35 each = ______ 10 to 49 computers: ____ computers at $25 each = ______ 50+ computers: ____ computers at $10 each = ______ WinPatch Professional ____ copies at $300 each = ______ WinPatch Enterprise ____ copies at $1,000 each = ______ WinPatch Enterprise ____ copies at $3,000 each = ______ + Full Source Code Pennsylvania residents add 6.00% sales tax + ______ Total payment ______ Name: ______________________ Date:___________ Company: _______________________________________ Address: _______________________________________ City, State, Zip: _______________________________________ Country: _______________________________________ Day Phone: ______________ Eve: _________________ Electronic Mail address: ________________________________ How did you hear about WinPatch? __________________________ Comments: WinPatch Credit Card Ordering Information: Internet online ordering: http://www.artistryinsoftware.com/products/winpatch/Order.htm MasterCard, Visa, American Express, and Discover orders must be placed through DigiBuy. The WinPatch product number is: 15145. The best way to reach DigiBuy is by fax to 1-713-524-6398. You can also call DigiBuy at 1-800-242-4PsL(4775) Extension 15145 or 1-713-524-6394 Extension 15145 between the hours of 7:00 am and 6:00 pm CST Monday-Thursday and 7:00 am and 12:30 PM CST on Fridays, except holidays. Credit card orders can be mailed to DigiBuy at P.O. Box 35705, Houston, TX 77235 USA. PsL requires the following information: Credit Card [ ] MasterCard [ ] VISA [ ] AMEX [ ] Discover Credit Card Number: _____________________________________ Expiration Date: _____________________________________ Name On Card: _____________________________________ Billing Address: _____________________________________ _____________________________________ _____________________________________ If your ship-to address is different from the address above please include the WinPatch order from from the previous page. *** Artistry, Inc cannot be reached at the numbers *** above. These numbers are for DigiBuy, a credit card order *** taking service only. Any questions about the status of the shipment of an order, refunds, registration options, product details, technical support, volume discounts, dealer pricing, site licenses, etc., must be directed to Artistry, Inc., PO Box 115 Blue Bell, PA 19422, USA or by Internet mail to sales@artistryinsoftware.com. Purchase Orders: Purchase orders (net 30 days) are accepted only from government and accredited educational institutions and major corporations, provided that they are submitted on purchase order forms with a purchase order number. Please be sure to include the standard WinPatch order form with a purchase order.