Visual Sequence Editor Order Form

Send to: Vised
	 487 Aquila Place
	 Parksville, BC
	 Canada
	 V9P 1C1

Name___________________________________________ Date____________

Organization___________________________________ Phone___________
                     
Street_________________________________________ FAX_____________

City__________________ Country_________ ZIP/Postal code_________

Email___________________________________________________________	

 

                ALL AMOUNTS ARE UNITED STATES DOLLARS

SINGLE USER LICENSE:    @ $30.00                      = _______ 

SITE LICENSE:   Must supply a proper business name.
   3 to  9 computers 	@ $21.00 each X ____units     = _______
  10 to 29 computers 	@ $19.00 each X ____units     = _______
  30 to 99 computers 	@ $15.00 each X ____units     = _______
 100 &  up computers	@ $11.00 each X ____units     = _______

        Total (US funds only)                           _______

Method of payment:  Cheque__           
                    Money order__ 
                    Purchase order__   


Purchase order number: (Universities only)______________________   			


Signature_______________________________________________________