SpaceMan 98 Order Form
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Use this order form to order SpaceMan 98 by fax, email or mail.

Fax to:   713-524-6398
Email to: 15633@pslweb.com
Mail to:  PSL, P.O.Box 35705, Houston, TX 77235-5705

To order online, go to www.extrabit.com, and select "Order Online".

To order by phone, call 800-242-4775 ext 15633, or 713-524-6394
ext 15633, Monday to Friday, 8:30 a.m. to 5:30 p.m. CST.
NOTE: The operators on these numbers can only deal with credit
card orders.  They will not be able to answer any questions
about SpaceMan 98.  If you have any questions, send email to
info@extrabit.com

If you are not ordering by credit card, leave out the credit
card details section, and make checks payable to "PsL".
Checks must be in US$ and drawn on a US bank.

Leave out any details that do not apply (such as Company Name).


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Purchase order for SpaceMan 98, product code 15633

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Ship-To Name & Address:

Name.....................

Company Name.............

Address 1................
Address 2................
City.....................
State/Province...........
Zip......................
Country..................

Phone # (voice)..........

email address............

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Credit Card Details

Credit card number.......
Expiration month/year....
Banks name and phone #...
(Cards accepted: MC, Visa, Amex, Discover.
 The BANK's name and phone number will be on the back of the card,
 or on your statement.  For AMEX, just enter 'AMEX'.
 All others MUST have bank's name & phone number.)

Credit Card Holder's Name & Address
(Only required if different to the name and address above).

Name on card.............
Company name.............
Address 1................
Address 2................
City.....................
State/Province...........
Zip......................
Country..................
(NOTICE: Address verification is done on every charge.
 If the credit card billing name & address do not match
 the address above, THE ORDER WILL NOT BE PROCESSED.
 The best place to get the billing address is from the
 monthly statement.)

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Quantity

Number of licenses.......
Total cost...............
(1 license costs $15,
 2 to 9 licenses cost $5, plus $10 per license
 10 or more licenses cost $50, plus $5 per license)

Texas residents only:
Add 15% sales tax........


Total order value........

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