Logalizer Pro (product number 3283-2): order form ========================================================= Mail this form to: Register Now! Dept# 3283-2 PO Box 1816 Issaquah, WA 98027 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) Note: for mailed orders, the checks need to be made out to "Register Now!". For international checks, we would prefer the funds be drawn in US dollars. When this is not possible, we will accept checks for a corresponding amount in the country's currency. Unfortunately, Eurochecks are not accepted. A purchase order must be faxed or mailed to the address listed above with all necessary information including billing information. Order Information ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Logalizer Pro (3283-2) Price/Unit Quantity Total ---------------------------------------------------------------------- 1 Unit $34.95 ______ __________ 2 - 5 Units $29.95 ______ __________ Mail or fax order $2.50 __________ TOTAL AMOUNT ($U.S.) __________ Note: if you place an order by fax (with credit card), or pay with check, money order or purchase order, please include additional $2.50 (see above). Otherwise, your order will not be processed. If you place an order by phone, you'll be charged for additional $3. For online orders, there are no additional charges. 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: ______________