Order form for HTMLDocument Class Library - Please print and include with your order.
For Telephone orders:
Toll-Free: 1 800 999-2734
Regular: 1 (719) 576-0123
For FAX orders:
Regular: 1 (719) 623-0399
For Postal Mail orders:
RegNet (Wintronix, Inc.)
24303 Walnut Street, Suite 200
Newhall, CA 91321-2900
U.S.A.
A purchase order must be faxed or mailed to us with all necessary information
including billing information.
User information: (Note that email address is required) |
|
| First Name: | ______________________________________________________________ |
| Last Name: | ______________________________________________________________ |
| Company: | ______________________________________________________________ |
| Address line 1: | ______________________________________________________________ |
| Address line 2: | ______________________________________________________________ |
| City: | ______________________________________________________________ |
| State/Province: | _____ |
| Zip/Postal Code: | ________________ |
| Country: | ______________________________________________________________ |
| Phone number: | ______________________________________________________________ |
| Email address (required): | ______________________________________________________________ |
Order information: |
|
| _______ | Single License, Product ID: 10307, Unit Price: $99 |
| _______ | 4 Developers License Pack, Product ID: 10308, Unit Price: $189 |
| _______ | 10 Developers License Pack, Product ID: 10309, Unit Price: $299 |
| _______ | Site License, Product ID: 10310, Unit Price: $399 |
| _______ | Site License+Source Code, Product ID: 10311, Unit Price: $499 |
If you're paying with a credit card, please fill out the following information: |
|
| Name on credit card: | ______________________________________________________________ |
| Credit card type (circle one): | Visa / MasterCard / American Express / Discover (Novus) |
| Credit card number: | ______________________________________________________________ |
| Credit card expiration date (Month/Year): |
_____/______ |