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ORDER FORM. Please enter all
requested information.
Please print
this page fax it
to USA + 208.567.5425.
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First Name
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M.I.
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Last Name
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Company
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Street Address
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Suite
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Address
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City
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State
(US only)
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Zip (US only)
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-
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Postal Code
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Country
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Country |
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Phone
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Fax #
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Email
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Key No.
(for upgrades only)
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| CREDIT CARD INFORMATION
Name on Card
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Type
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Card #
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Exp Date
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Mon.
Yr |
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| ITEMS PURCHASED |
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New orders specify:
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OptiCADŽ $3500
1 Yr. Support & upgrades $ 750 |
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Parallel port key
USB key
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| SHIPPING |
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| Select Destination
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Privacy Statement -- Opticad
retains all sales contact
information strictly for internal use. |