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Win-Secure-IT® Credit Card ORDER FORM
Copyright© 1995-2001 Shetef Solutions & Consulting Ltd. 
All Rights Reserved. 

Product ID: 8694

Win-Secure-It® Single Copy ____ copies at $29 each = ______ 

Win-Secure-It® Site License 
   2 to   9 computers: ____ computers at $22 each = ______ 
  10 to  24 computers: ____ computers at $17 each = ______ 
  25 to  49 computers: ____ computers at $14 each = ______ 
  50 to  99 computers: ____ computers at $12 each = ______ 
 100 to 199 computers: ____ computers at $11 each = ______ 
     (more than 199 copies are negotiable) 

(Just for example, if you would like to buy 15 copies then
 the Total payment will be : 15 copies x 17$ = 255 $) 


Credit Card:     [ ] MasterCard  [ ] VISA  [ ] AMEX  [ ] Discover

Credit Card #:   ________________________________________________

Expiration Date: ___________________ Today's Date: ______________

Name On Card: ___________________________________________________

Signature: ______________________________________________________

Name: ___________________________ Date: _________________________

Company: ________________________________________________________

Address: ________________________________________________________

City: __________________________ State __________________________

Postal Code: ___________________ Country: _______________________

Day Phone: _____________________ Eve: ___________________________

Electronic Mail Address: ________________________________________

Where did you hear about Win-Secure-IT® ?  ________________________
_________________________________________________________________

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