Gadwin, Ltd. printable order form ================================================================== Mail this form to: Register Now! ATTN Orders P.O. 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) Check, money order, purchase order or credit card order accepted ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Note: for mailed orders, the checks need to be made out to "Register Now!". The product ID(s) (see below) should be mentioned on the "memo" of the check. For international checks, we would prefer the funds be drawn in US dollars. 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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Product(s) ID# Price/Unit Quantity Total ---------------------------------------------------------------------- Diagram Studio 5679-9 $49.95 ______ _______ Gadwin GeForms 5679-6 $29.95 ______ _______ Gadwin PrintScreen Pro 5679-10 $24.95 ______ _______ Gadwin Web Snapshot 5679-12 $24.95 ______ _______ ---------------------------------------------------------------------- GRAND TOTAL: ________________ 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: ______________