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ORDER FORM

Please print out this form. Fill it out. Fax or mail to:

InfoWorks Technology Company
P.O. Box 2261
Cranberry Township, PA 16066
FAX (412) 635-9218
Phone (412) 635-9224

Item Qty Cost Total
Link Checker      US$495  
Link Checker Upgrade    US$345  
Shipping & handling      Free
Total (US$)    
 

Shipping and billing information:

Name __________________  Phone _________________  Email _____________________

Ship to

__________________________

 Bill to

_____________________________

Address

__________________________

 Address

_____________________________

__________________________

_____________________________

City

__________________________

 City

_____________________________

State

_____  Zip Code ____________

 State

 ______  Zip Code ____________


Please check one of the following ways of payment:

___ Bill Us:  P.O. #_______________

___ Prepaid Check enclosed (Payable to InfoWorks Technology Company

                        
Authorized Signature/Date ________________________________

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