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- 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: _______________________________________________
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- 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:____/____