Order form for Log Info v3.00 - 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: |
Log Info - Single Server $99.99 USD per license Qty _________ Log Info - Site License $499.99 USD per license Qty _________ Log Info - Enterprise License $1,499.99 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 |