| TO: | Date:______________________ |
| ARJ Software, Inc. | |
| P.O. Box 249 | |
| Norwood MA 02062 | Fax: 508-339-1070 |
| USA | Email: sejung2@aol.com |
FROM:
Name: ____________________________________________________________
[Company]: ________________________________________________________
Reg Name: _________________________________________________________
[Used to register stamp your software, 50 characters max]
Address: __________________________________________________________
| City: ________________________________ | State: ___________________ |
| Country: ____________________________ | Postal Code: _____________ |
| Phone: ____________________________ | Fax: ____________________ |
| Email: _____________________________________________ |
| 1 computer | at $45 ______ |
| 2 to 8 computers | at $30, nbr computers ___x 30 = ______ |
| 11 to 40 computers | at $25, nbr computers ___x 25 = ______ |
| 51 to 75 computers | at $20, nbr computers ___x 20 = ______ |
| 101 to 174 computers | at $15, nbr computers ___x 15 = ______ |
| 201 to 384 computers | at $13, nbr computers ___x 13 = ______ |
| UNLIMITED single location site license | at $2500 total fee = ______ |
| UNLIMITED multiple location site license | at $5000 total fee = ______ |
| 2 to 10 computers | at $15, nbr computers ___x 15 = ______ |
| 11 to 50 computers | at $13, nbr computers ___x 13 = ______ |
| 51 to 100 computers | at $10, nbr computers ___x 10 = ______ |
| 101 to 200 computers | at $8, nbr computers ___x 8 = ______ |
| 201 to 500 computers | at $7, nbr computers ___x 7 = ______ |
| 501 to 1000 computers | at $6, nbr computers ___x 6 = ______ |
| Optional software/documentation diskette | at $5, ___x 5 = ______ |
| JAR-SECURITY ENVELOPE signature | FREE |
*** NO SOFTWARE/DOCUMENTATION DISKETTE IS INCLUDED IN FEE.
*** THE REGISTRATION KEY PROVIDED WILL UNLOCK YOUR SHAREWARE JAR.
List the exact name to be displayed by the JAR security envelope.
The display will look like the following lines:
*** JAR-SECURITY envelope signature:
*** _____________________________________________________________ R#nnnn
(Exact name or identifier, one line, 66 characters max)
FIFTY percent discount for ARJ licensees purchasing a JAR license of EQUAL or LESSER value -______
Massachusetts state residents add 5 percent sales tax ______
TOTAL ORDER (Minimum credit card order is $10.00) ______
For payment by check NOT payable through a USA bank, add $40.00 ______
TOTAL ENCLOSED ______
[TOTAL ENCLOSED IN FOREIGN CURRENCY] ______
| ( )Cash | ( )Check | ( )Bank transfer |
| ( )Purchase Order | ( )Money order | ( )Credit card (fill out form below) |
AUTHORIZED SIGNATURE (if needed): ______________________________________
TITLE: ______________________________________ DATE: _____________________
Name: _________________________________________________________
[Company name]: _________________________________________________________
Billing Address: _________________________________________________________
: _________________________________________________________
: _________________________________________________________
ZIP code / Postal code: ___________________
Payment by: ( ) MasterCard
( ) Visa
( ) American Express ( ) Discover
Card #: ______________________________________
Expiration Date: ______________
Signature of cardholder:_______________________________________________________
Payment may be made by a check NOT payable through a USA bank for amounts over $100.00 (USA). Please make the payment in USA funds and add a $40.00 surcharge to cover handling and bank transfer costs.
Payment may be made by credit card (MasterCard, Visa, or American Express).
Please allow one to three weeks for delivery depending upon your local
postal system.
| ( ) Compression | ( ) Multiple volumes |
| ( ) Pricing | ( ) Features |
| ( ) Support | ( ) REARJ |
| ( ) Documentation | |
| ( ) Other ______________________________________________ |