| Name: | ______________________________ |
| Business: | ______________________________ |
| Address: | ______________________________ |
| ______________________________ |
| City: | ______________________________ |
| State/Province: | ______________________________ |
| Postal Code: | ______________________________ |
| Phone: | ______________________________ |
| Fax: | ______________________________ |
| Email: | ______________________________ |
Management by Statistics |
| Single user version ($295.00*) | __________ |
| 5 user version ($595.00) | __________ |
| 10 user version ($895.00) | __________ |
| 25 user version ($1295.00) | __________ |
| Sales Taxes (California 8.25% or Florida 7%) | __________ |
| Shipping (US $8.00/Canada $12.00) | __________ |
| Total | __________
|
| Credit card #: | ________________________________ |
| Experation Date: | __________ |
| Signature: | ________________________________ |