HOW TO ORDER POLICIES ON DISK
** Non-secure Order Form **

Orders from outside the U.S. must pay in U.S. dollars.
Be sure to include your complete mailing address.

BY CREDIT CARD USING THIS ORDER FORM:

I accept MasterCard or Visa.
Fill out the order form below and e-mail or fax it to me.

My Fax number is: (512) 241-2817

STATEMENT OF CONFIDENTIALITY:

This information will only be used to fill your order and support your customer relationship. It will not be sold, given to, or shared with anyone else.

Name:
Company Name:
Street:
City: State: ZIP:
Outside U.S.: Province/Country/Postal Code:
Phone number:
FAX number:
Email:
Number of employees:

Credit Card Information
Name on card:
Credit Card number:
Date of expiration: Type of card:

Your order will be sent out within 1 business day of receiving it.

Please indicate what you are ordering:

Please select delivery format:

If disks, please select method of shipping:

(If disks shipped to a different address) Ship to:

Name:
Street:
City: State: ZIP:

If shipped via FedEx, preferred method of billing:

FedEx Account #

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