Order Form & Instructions

*** This form is for check and money order purchases only ***
*** See README.TXT for other payment methods ***

1) Fill out the address, phone, and e-mail information. 
2) Indicate the number of licenses and compute the subtotal.
3) Print this file.
4) Make out a check or money order drawn on a US bank for 
   the total amount. Make Checks payable to: 
      Ciemian Computer Services.
5) Mail the order form and payment to:
      Ciemian Computer Services
      2125 Crescent Drive
      Signal Hill  CA  90804-5622
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              Name:
           Company:
    Street Address:
              City:
    State/Province:
Zip or Postal Code:
           Country:
         Telephone:
               Fax:
            E-Mail:
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Products                             Price   Quantity   Subtotal

acMenus Delphi Components Single Developer License
  1  License      (1 - 3.5" disk)      $45 US x _____ = $ ______
  10 License Pack (2 - 3.5" disks)    $350 US x _____ = $ ______
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Taxes, Shipping, and Handling

Just to make it easy, direct mail price includes 
all applicable taxes and shipping and handling fees.
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Total                                               Total Amount

US check or money order payable 
to Ciemian Computer Services.                          $ _______
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