ExpressAccounting - Order Form

Please print and complete this order form and fax or mail with payment information to the number or address below.  We will promptly forward your serial number and permanent registration code via email and fax. 

 

Your Name: ___________________________________________________

 

Company Name: _______________________________________________

 

Address: _____________________________________________________

 

City: ________________________________________________________

 

State: __________________________  Postal Code: ________________

 

Phone: __________________________  Fax: _______________________

 

Email Address: ________________________________________________

(Note: Email address is used for registration and update notification).

 

Do you need a CD mailed to you?    £ Yes   £ No

 

Product (Select by entering qty & extending price) Price Ea. Qty Ext. Price
ExpressAccounting 1-5 Concurrent Users (includes 1 year Annual Maintenance & Updates) $1,295    
ExpressAccounting 6-10 Concurrent Users (includes 1 year Annual Maintenance & Updates $1,895    
ExpressAccounting Unlimited Concurrent Users (includes 1 year Annual Maintenance & Updates $2,495    

Total Charges (please total, no charge for shipping)

 

------ ---> $              

 

Payment:   £ MasterCard    £ Visa    £ AmericanExpress    £ Check Enclosed

      £ Purchase Order (must be included, subject to approval)

 

Card Number: _______________________________  Expiration: ____ / ______

 

Name On Card: ____________________________________________

 

Authorized Signature: _______________________________________

 

 

Please fax or mail order form to:

 

Dealer Code: ___________

Express Technology

P.O. Box 372

Fairhope, AL 36533

Phone: 888-565-0127 or 251-929-3200

Fax: 888-891-8292 / 251-929-3211