This order form is for Money Order - CREDIT CARD - USA CHECKS and PayPal Orders

* indicates a required item

*How did you hear of us?

*Your First Name ------>

*Your Last Name  ------>

If this is to be registered in another person's name 
(as if you are buying them a gift)
then put their name here as the software will be registered in their
name and their address:
Other person's First Name 	
Other person's Last  Name 

Company Name----> (optional)
*Street Address->
*City----------->
*Province/State->
*Zip/Postal Code>
*Country-------->

*Complete Telephone Number (including country and area code) exxample 1-992-555-1212


*E-Mail address  

 I have or will download the software on the internet (do not send disks or CD)I NEED you to send me CDROM of the software (I've added the extra \$)
(choose 1)(Note:You can create the old floppy disks from the CDROM or website if needed)

PRICES: US Dollars (Note:One copy has to be purchased per computer)
Click here for information about regular version or network version

For conversion to other currencies use PAYPAL below and 
PAYPAL will show you the converted amount in your country

Quantity                Regular Version      Network Version
Quantity 1 (first copy)$ 39.95             $49.95      
           (if you are over 60 years old you can take a discount of $10 off regular prices (only if you need the discount as we are a small software company)
Additional copies      $ 29.95 each.       $39.95 each.
Over 20 copies please call us for bulk pricing.
DEMO on CD only        $  5.00             $ 5.00

I am ordering     
 registration code  at $
and an additional 
 registration codes at $ each.
Additional copies are for you only within your company or personal use.
You can not order additional copies for friends for discounted rates as
each additional copy is registered under your name only.
Note: One registration code per computer.  
The registration code will unlock the demo copy to a FULL Version and
unlock the CD-ROM version if you are ordering a CD-ROM.

Payment Information---------------------------------------------------

I will be paying by  Visa Credit CardAmerican Express Credit CardMastercard Credit CardDiscover Credit CardPayPalUnited States CheckInternational Check (add 5.00) to your order.Does Not Apply
Wire Transfer (we will e-mail you transfer information)
  (use PAYPAL for non US DOLLAR payments if you like)
If payment is by credit card enter credit card information below:
Enter the card number here (required)
Expiration Date            (required)
Exact Name on credit card  (required)
Street or PO box the credit card statements are mailed to:
                           (required)
ZIP/Postal CODE the credit card statements are sent to (required)
3 or 4 number security code printed on the credit card (required)
This # is the last 3 or 4 #'s on the front or back (not the card #)

Custom Database Conversion Charges------------------------------
(only fill this in if you paid custom conversion charges to convert
 your current database to our format)
As quoted by you, I agree to pay an additional US $   
for customization of mdb2000 or conversion of my current database 
into MDB2000 format which is the same as (Microsoft Access 7.0 format - Access 97)
Custom version of mdb2000 require a separate email describing your needs prior to 
filling out this order form so that you can put the proper $ amount in the box
above.
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CD-ROM Option
I have added $5.00 above to the price as I need A CD-ROM copy of the software. 
Shipping Destination (if not USA)
I have added $5.00 for shipping to NON-USA address
Minnesota Residents
I live in Minnesota USA and please add 6.5% sales tax of $ dollars.
    Tax examples are 39.95 = 2.60 tax or 44.95 = 2.92 tax 
IF you have a PROMOTIONAL CODE please enter it here 
(if you don't know what this is...then it does not apply to your order)

If paying by check---allow 7-10 days after we receive your check for us to ship
your software. Send checks to the address at the bottom of this page.

The total amount I will be paying you is $ US dollars.  
(please include all additional charges above that may apply)
You agree to the above by clicking on the button below.

PAYPAL orders will have an order screen come up after this form

Security Note

We are VERY serious about your credit card number security and therefore do NOT
store card numbers
in a database on the web.  The are transmitted to our PC database in our
office.
 
NOTE: Your machine's ID # is sent in encrypted form to us so we can 
verify you are the credit card holder and you are the sender of the e-mail.

Thank you!