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ORDER.FRM
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2000-11-30
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Advanced Administrative Tools (product number 2631-1): order form
==============================================================
Mail this form to: Universal Commerce, Inc.
ATTN: Orders
PO Box 1816
Issaquah, WA 98029
United States of America
Or fax it to: 1 888 353-7276 (U.S. and Canada; toll-free)
1 425 392-0223 (other countries; regular)
Or just call: 1 877 353-7297 (U.S. and Canada; toll-free)
1 425 392-2294 (other countries; regular)
Check, money order, purchase order or credit card order accepted
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Note: for mailed orders, the checks need to be made out to Universal
Commerce Inc. The product ID (2631-1) should be mentioned on the
"memo" of the check. Checks and money orders should be drawn in US
Funds. A purchase order must be faxed or mailed to the address listed
above with all necessary information including billing information.
Order Information
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Advanced Administrative Tools (2631-1) Price/Unit Quantity Total
----------------------------------------------------------------------
Single License @ $39.95 ea. Quantity: _____ Total:_________
Site License
2..9 Users @ $31.95 ea. Quantity: _____ Total:_________ 20% (discount)
10..50 Users @ $27.95 ea. Quantity: _____ Total:_________ 30% (discount)
51..100 Users @ $15.95 ea. Quantity: _____ Total:_________ 60% (discount)
101..250 Users @ $9.95 ea. Quantity: ______ Total:_________ 75% (discount)
251+ Users @ $3.95 ea. Quantity: ______ Total:_________ 90% (discount)
TOTAL PURCHASE: $ ($U.S.)_____________________________________________
Payment Information
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
First Name: _____________________________________________________
Last Name: _____________________________________________________
Company: _____________________________________________________
Street Address: _____________________________________________________
_____________________________________________________
City: _____________________________________________________
State/Province: _____________________________________________________
Zip/Postal Code: _____________________________________________________
Country: _____________________________________________________
Daytime Phone: _____________________________________________________
Fax: _____________________________________________________
Email Address: _____________________________________________________
Payment: __ MasterCard __ VISA __ AMEX __ Discover
__ Check __ Money order __ Purchase order
For credit card orders:
Name on Card: ________________________________________________________
Credit Card Number: __________________________________________________
Expiration Date: month _______________ year (4 digits) _______________
Signature : ____________________ Date: ______________