Order form for Group Net Send v1.01 - by RJL Software Inc.
Full Name: _____________________________________________
Company Name: _____________________________________________
Street Address: _____________________________________________
City, State, postal code: _____________________________________________
Country: _____________________________________________
Phone Number: _____________________________________________
Fax Number: _____________________________________________
Email Address: _____________________________________________
Most Important! We use email to communicate with you.
Product Ordered: Group Net Send - Server License
$49.99 USD per license    Qty _________

Group Net Send - Site License
$249.99 USD per license    Qty _________
Payment Details
(circle one):
Credit Card     Money Order     Purchase Order
PO Number
(if applicable):
Credit Card Type
(if applicable):
Visa     Mastercard     American Express     Discover
Name on Card: _____________________________________________
Card Number: _____________________________________________
Expiration Date: __________________
Date / Signature: _____________________________________________
If paying by money order, make it payable to: RJL Software, Inc. 340 Warwick Lane LITH, IL 60156
If ordering by fax, please fax this form to (847) 841-4216