Order form for TreeGX - Please print and include with your order.
For FAX orders:
Regular: 1 (323) 316-9612
For Postal Mail orders:
DevComponents LLC
24312 Knollwood
Novi, MI 48375
USA
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, Unit Price: $284 we will apply appropriate discounts based on number of licenses you order. |
| _______ | Site License, Unit Price: $1899 |
If you're paying with a credit card, please fill out the following information: |
|
| Name on credit card: | ______________________________________________________________ |
| Address on file with credit card company: | ______________________________________________________________ |
| Credit card type (circle one): | Visa / MasterCard / American Express / Discover (Novus) |
| Credit card number: | ______________________________________________________________ |
| Credit card expiration date (Month/Year): |
_____/______ |