I would like to upgrade to the Standard Version of IntelliFIX 2000
(Hardware Test & Fix and Software Test & Fix). Please find my
mailing and billing information below. Upon receiving the information,
I understand that Intelliquis International will (Select One) ___fax, ___phone or ___email my unique and personal UPGRADE KEYCODE to upgrade to the Standard Version of IntelliFIX 2000.
CUSTOMER INFORMATION:
Customer Full Name: :FirstName :LastName
Company Name: :CompanyName
Customer Address: :Address
City,State,ZipCode: :City, :State :ZipCode
Country: :Country
Customer Phone No: :PhoneNo
Customer Fax No: :FaxNo
Email Address: :EMail
BILLING INFORMATION:
Credit Card ****** :CardType ******
Card Holder ****** :NameOnCard ******
Account# ****** :Account ******
Expiration Date ****** :ExpirationDate ******
Vendor ID# ***** :VendorID *****
Serial # ***** :SerialNo *****
PRODUCT PRICING:
Upgrade to Standard Version = USD$49.95
Utah Residents add 6.35% sales Tax=USD$3.17
Signature:
_________________________
- - - - - - - - - - - - Please do not fill the following - - - - - - - - - - - -
Please Find your Unique and personal Upgrade Keycode below: