Printable Order Form ![]()
| Description | Qty |
Price |
Subtotal |
| Chattels (Already have Access 97) | $ 400 | ||
| Chattels (Already have Access 2000) | $ 400 | ||
| Chattels (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.) | ||||||||
| Credit Card | Visa | MasterCard | Credit Card # |
|
Exp Date: |
|
||
| Signature: |
|
|||||||
|
Send Order Form To: |
||||||||