Appendix B: ServerStat Lite Registration and ServerStat Order Form

Instructions: You can use this form to order commercial ServerStat or register ServerStat Lite shareware through the postal mail, through e-mail or use a company/school purchase order.  Be sure to include all information requested below.  This will insure that we can get the order correct and we can call you if a problem arises.  Thank you for your cooperation and your order. PLEASE print neatly.
     You can give us a PO number over the phone, but we must receive a hard copy.  We will send a copy e-mail within one business day and (if shipping included) the package when the PO arrives.
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Your Name:  ______________________________________________________________________________________
Business Name:  ___________________________________________________________________________________
Address:  _________________________________________________________________________________________
Address 2 (if needed):  _______________________________________________________________________________
City:  __________________________________________  State: ______________  Zip Code: ___________________
Country:  ___________________________________________
Phone:  (Area Code___________) - _______ - ___________________ Ext: _______________
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E-MAIL ADDRESS (required for electronic update/upgrade notices and electronic delivery):
_________________________________________________________________________________________________
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PAYMENT:     ____ VISA     ____ MC     ____ Check     ____ Purchase Order #________________________________
If using a credit card, give card number,expiration date, signature and today’s date:
_____________________________________________________________  expires: ___/___

Signature: ________________________________________________   Date _____________

Price:
       Shareware Pricing:
_______  $20.00 single user
       Educational Pricing:
_______  $29.95 single.
_______  Plus $10.00 per additional administrated server.
_______  - $15.00 credit if have paid shareware fee
       Commercial Pricing:
_______  $ 69.95 Up to 3 servers.
_______  Plus $25.00 per additional server company-wide.
_______  - $ 20.00 credit if have paid shareware fee.
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_______  Shipping  (FREE if e-mail delivery,  $ 4.00 in US if you want a disk sent to you - $6.00 Canada - $8.00 elsewhere)
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____________  TOTAL
Send to:
Kitchen Sink Software, Inc.
903 Knebworth Ct.
Westerville, OH 43081-2753
800-235-5502 (continental US)
614-891-2111 (central Ohio and everywhere else)
Forsythe.14@osu.edu (sales and registration)
Bush.49@osu.edu (tech support)