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Cream of the Crop 20 (Terry Blount) (1996).iso
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ORDER.FRM
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1996-05-24
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*** ORDER FORM PAGE 1 ***
Complete this form and mail with required fee to register LEHIPEDS.
Your registered software will be sent on the next business day after
we receive your order.
REGISTRATION INFORMATION:
Name of Registered User:_____________________________________________
Name of Practice:____________________________________________________
Address:_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Phone:_______________ FAX:_______________ Email:_____________________
Other Info:__________________________________________________________
PRICING INFORMATION (Prices are subject to change without notice):
The regular license price for LEHIPEDS is $325.00 plus postage. This
price is the same for use as a single user program or as a network
program. The program runs equally well in either mode. A network is
defined as any number of connected computers associated with one
medical practice in a single office. For this, one license is needed.
If you use the program in different offices, or use the program in
different medical practices within the same office, you must purchase
a site license. Refer to Manual for information about site licenses.
As a special introductory offer, through December 31, 1996, we are
offering LEHIPEDS registration at the unbelievable value of $125.00.
This special offer does NOT apply to the site license price.
LEHIPEDS Registration...................... $325.00 ______________
LEHIPEDS Registration
Special Price thru 12-31-96.............. $125.00 ______________
Non-Registered Disks for evaluation
Applied to price when registered......... $ 15.00 ______________
Site License: Must purchase single registration for first site.
Special price above does NOT apply for registration of first site.
Each additional site (multiple offices or practices) is $150.00.
Number of additional sites......... ____ @ $150.00 ______________
Postage & handling......................... $ 10.00 10.00
TOTAL .................... ______________
*** ORDER FORM PAGE 2 ***
** Payment by check or money order...
Mail payment + this order form to:
Marilyn S. Holt
1140 Lee Blvd. Suite 108
Lehigh Acres, FL 33936
. . . . . .
** Payment by credit card...
Complete the following information:
Master Card ( ) VISA ( )
Card Number: ____________________________________________________
Expiration Date: ________________________________________________
Name of Card Holder _____________________________________________
Signature of Card Holder ________________________________________
Three ways to pay by credit card:
- Mail BOTH PAGES of order form to address indicated above.
- FAX BOTH PAGES of order form to: (941) 368-1331
- Telephone order/credit card information to: (941) 368-3810
. . . . . .
Disk Size (will send 3 1/2" if not specified):
3 1/2" ( ) 5 1/4" ( )
THANK YOU FOR SUPPORTING THE SHAREWARE CONCEPT!