Norsys - Mail Order Form

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Mail Order Form

Please print, fill out, and fax completed form to +1 604.221.2238 or mail it to the below address. Or instead, you may wish to use the online order form, or get info to fill out a purchase order.

Norsys Software Corp.
3512 West 23rd Avenue
Vancouver, BC, Canada V6S 1K5

Bill To:
Name	____________________________________
Organization	____________________________________
Street Address	____________________________________
	____________________________________
City	____________________________________
State/Province	____________________________________
Country	____________________________________
Zip/Postal Code	____________________________________
Email	____________________________________
Phone	____________________________________

Technical Contact:	(fill out if the primary user of Netica will be different from the above)
Name	____________________________________
Email	____________________________________

Send To:	(fill out if ordering disk and manual, and their destination is different from above)
Name	____________________________________
Organization	____________________________________
Street Address	____________________________________
	____________________________________
City	____________________________________
State/Province	____________________________________
Country	____________________________________
Zip/Postal Code	____________________________________
Phone	____________________________________

____ copies of Netica Application
	@ $585	$ ________
	(educational price $285)

	____ for MS Windows (95/98/Me/NT4/2000/XP/Vista)

____ copies of Netica API Programmer's Module
	@ $685	$ ________
	(educational price $285)

	____ for MS Windows (95/98/Me/NT4/2000/XP)
	____ for Linux
	____ for AIX
	____ for MacOS
	____ other ______________

	(C version only) If not downloading, add $145 for paper manual, disks & shipping	$ ________
	(Java version only) If not downloading, add $85 for paper manual, disks & shipping	$ ________


Subtotal		$ ________

Canadian residents only, add 5% GST		$ ________
BC residents only, also add 7% PST		$ ________

Total (US $)		$ ________

All prices are in US dollars. Purchase price includes support by email and upgrades for one year (by download).

Special instructions, P.O. Number, VISA, MasterCard, or Amex number and expiry, etc.: