Printable Order Form 

Description Qty

Price

 Subtotal
CAP (Already have Access 2000)   $   400  
CAP (w/Access 2000 Run-Time)   $   550  
Additional Reports, each   $     75  
Additional Programming, per hour  

$     50

  
Non-distributable Code  

$ 1200

  

Order Subtotal:

  

Tax (6% KY or attach copy of Tax Exempt Certificate):

  
Shipping:

Free
Total:  

Shipping Information

Billing Information
Name/Attn:  
Name/Attn::  
College:  
College/Company:  
Address:  
Address:  
   
   
City, State Zip:  
City State Zip  
Phone No:  
Phone No:  
Method of Payment
30 Day Net - Purchase Order Required (please attach in-house PO)

PO#:

 

Check (Make Payable to M & M Programming, Inc.)
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Signature:  

Send Order Form To:
M & M Programming, Inc.
110 North Spalding Avenue
Lebanon, KY  40033