To order by fax or mail, please print out this order form, fill in all necessary information and
|
mail it to Exody E-Business Intelligence GmbH - Orders - Hauptstraße 129 65760 Eschborn GERMANY |
or fax it to
+49 61 96 95 99 150 |
| Company: | _____________________________________________ |
| Department: | _____________________________________________ |
| Name: | _____________________________________________ |
| Title: | _____________________________________________ |
| Address: | _____________________________________________ |
| City: | _____________________________________________ |
| State/County: | __________________________ Postal Code: ________ |
| Phone: | _____________________________________________ |
| Fax: | _____________________________________________ |
| E-Mail: | _____________________________________________ |
| VAT#: | _____________________________________________ |
| When ordering from EU countries, except Germany, please enter your VAT# (incl. country code) to be exempted from VAT. |
I hereby order:
| __ | WebSuxess 4 Enterprise Edition Single User License(s) for Euro 750 |
| __ | WebSuxess 4 Enterprise Edition ISP License(s) for Euro 2000 |
| __ | Update to Enterprise Edition 4 from Enterprise Edition 3.0 for Euro 225 |
| __ | Update to ISP License 4 from ISP License 3.0 for Euro 450 |
| __ | Upgrade to Enterprise Edition 4 from StartUp Edition 4 for Euro 650 |
| __ | Upgrade to ISP License 4 from Enterprise Edition 4 for Euro 1250 |
| __ | ShopSuxess Enterprise Edition 4 for Euro 2600 |
Method of Payment:
[ ] Please bill me.
[ ] Please charge my MasterCard/Eurocard.
| Credit card holder: | ______________________________ |
| Credit card number: | ______________________________ |
| Expiration date: | ______________________________ |
| __________ | ________________________ | ||
| Date | Signature |