PingGraph Registration Form

  1. Fill out the form with your web browser, including the total amount due.
  2. Print the completed form.
  3. Mail the form to Infix Technologies along with either a check or money order in US funds or a purchase order.

Infix Technologies
7062 S 3075 W
West Jordan, UT 84084
(801) 255-4090


Name
Title
Company
Full Mailing Address
Phone, Ext.
Fax
Email
Quantity License Type Unit Price Amount
Single License

$29

2-5 Licenses

$24

6-20 Licenses

$19

21+ Licenses

$14

Utah residents add Sales Tax

6.1%

Total