Print the form by selecting Print from the File menu, and then complete and mail to the address below. CompuBridge Speller Product Order Form

Date: _______________________________________________________
Name: _______________________________________________________
Company: ___________________________________________________
Address: ___________________________________________________
City, State, Zip: ______________________________________________
Country: ___________________________________________________

Day Phone: ____________________________________________________
Eve Phone ___________________________________________________
Fax: ___________________________________________________

Electronic Mail address: _______________________________________
(Please double check your e-mail address; one small typo and we won't be able to communicate with you about your order.)

If pay by credit card
Credit Card Number: _________________________________
Expiration Date _________________________________

Credit Card Holder's Name: _________________________________
Billing Address (if different from above):

City, State, Zip: ______________________________________________
Country: ___________________________________________________

How did you hear about the CompuBridge Speller Product? __________________________
Comments:

Speller for Microsoft Products ____ copies at $14.95 (Regular price $19.95) each: ___________

AutoSpell Max (AutoSpell Spell Checker + AutoSpell Typing Helper) : ____ copies at $34.95 (Regular price $39.95) each: ___________

AutoSpell Spell Checker : ____ copies at $24.95 (Regular price $29.95) each: ___________

AutoSpell Typing Helper : ____ copies at $14.95 (Regular price $19.95) each: ___________

AutoSpell Setup Disk: ____ copies at $4.95 each: ___________

Total Payment: $ ___________

Please make all checks payable to: CompuBridge
Mail to:
CompuBridge, Inc.
12235 Broadleaf Lane
Alpharetta, GA 30005

Thank you. We hope you enjoy using the CompuBridge Speller Products.