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1991-02-01
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56 lines
----------------------------------------------------------------------
FAX this form to: (206)-525-1331
or mail to:
CalcTech, Inc.
6014 NE 60th Street
P.O.Box 15277
Seattle, WA. 98115-0277
----------------------------------------------------------------------
XACT CALCULATORS - Version 5.1
Site License Registration Form
Use this form to obtain a site license for your company or
group. Your registered copy will be sent via U.S. mail.
I wish to register XACT CALCULATORS under a multiple (site)
license agreement. Please license my organization to allow
us to duplicate up to: (check one)
[ ] 10 copies .................................... $100.00
[ ] 100 copies ................................... $350.00
[ ] 1000 copies ................................. $1000.00
WA. state residents add 8.2% ................ $_______
TOTAL $_______
Company or Group Name: _______________________________________________
Your Name: ___________________________________ Phone: ________________
Address: _____________________________________________________________
City: ______________________________ State: _________ Zip: ___________
Method of Payment: (check one)
[ ] Check enclosed
[ ] Bill Me. Terms are NET 30, FOB Seattle, Washington
Our Federal taxpayer I.D. number is: 91-1382828
Purchase Order Number (optional): ___________________________
[ ] Charge my Visa or Mastercard
Cardholder's Name: __________________________________________
Credit Card #: ____________________________ Expires:____/____