WebMailer Order Form V1.0

		By Credit Card: Fax a completed Order Form with Credit Card Information to: (512)485-7555
By Mail: Enclose a check or money order made payable to GeoCel International in US Dollars drawn on a US Bank and mail in Order Form to: GeoCel International, Inc. 620 Congress, Suite 320 Austin, TX 78701 NOTE: We deliver all software orders by Email Attachment. Please include Email address. CUSTOMER INFORMATION
Name / Title:		___________________________________________________
Company Name:		___________________________________________________
Address:		___________________________________________________
		___________________________________________________
		___________________________________________________
Phone #:		_____________________________________________
Email Address:		______________________________________________
TECHNICAL SUPPORT INFORMATION
User Type:		_____ Web Developer _____ Corporate Intranet _____ Software Developer	_____ ISP _____ Web Master _____ Consultant
		___________________ Other (please specify)
Server Type:		_____Netscape Enterprise _____NetscapeCommerce _____Oracle Web Server _____SuperWeb Server	_____ Microsoft IIS _____ Purveyor _____ W4-Server _____ Commerce Builder
		___________________ Other (please specify)
Where on the internet did you discover WebMailer/GeoCel? _________________________________________________________
METHOD OF PAYMENT
(Circle One):		Check/Money Order		Credit Card
				Master Card VISA AMEX
Name As Exactly Spelled on Card:		___________________________________________________
Billing Address of Credit Card:		___________________________________________________
Credit Card Number:		__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
Expiration Date:		______________
Signature:		___________________________________________________
ORDER DETAILS
Type		Quantity Price		Total
WebMailer Lite - Single License**		________ x $49 =		_________
WebMailer Pro DB- Single License**		________ x $159 =		_________
WebMailer Pro - Single License**		________ x $129 =		_________
WebMailer Pro DB Upgrade - Single License** Upgrade from WebMailer Pro		________ x $59 =		_________
WebMailer Version Upgrade - Version upgrade from any WebMailer Product		________ x $19 =		_________
WebMailer Replacement Copy - Registration Number:________*		Please check the version for the replacement copy: Lite____ Pro____ DB_____ ________ x $35 =		_________
WebMailer Replacement Copy - No Registration Number		Lite____ Pro____ DB_____ ________ x $70 =		_________
	Licensing Packages	# of Additional Licences 5 10 25 50 100 Unlimited	Price $79 $149 $279 $499 $699 $999	_________
		Sub Total		_________
		Texas Sales Taxes (if applicable)		_________
		TOTAL DUE		========
For Texas Residents, please include 8.25% Sales Tax, Sorry, we cannot deliver software to Texas Residents without it. ** See License Agreement for details. Note: Please call for reseller and software integrator pricing. Should you have any ordering questions, feel free to Call 512-485-7550 *NOTE: to order a replacement copy, you must supply your registration number to qualify for the lower replacement cost.