PacTerm for Windows Order Form
---------------------

Please include your email address if you would also like to 
receive your serial number and activation key by email.  

Name:_____________________________________________________________

Call Sign:_____________	

Email address: ___________________________________________________

Street Address:___________________________________________________

City:_____________________________________________________________

State or Province:____________________  Country:__________________

Zip code or Country code:_____________  Phone No.:________________


____ Number of PacTerm for Windows copies

____ Email me my Activation Key

____ Serial number and Activation Key only (US $99.95 each)
     [Software downloaded from the Internet]

____ PacTerm for Windows upgrade from Pacterm 1.x (US $49.95)
     
____ Send copy of software On CD
     (US $99.95 plus $10.00 shipping & handling)
     (DX $99.95 plus $15.00 shipping & handling)

____ Printed manual (US $30.00 with software, $35.00 separately)
     Shipping and handling US added ($10.00) if ordered separately   
     Shipping and handling DX added ($15.00) if ordered separately   

____ ICOM Computer Interface Cable with any purchase (US $31.00)
     ($10.00 US Shipping & Handling if only item being shipped)
     ($15.00 DX Shipping & Handling if only item being shipped)

____ Purchase backup software on CD 
     (US $10.00 shipping and handling if purchased separately.
     (US $15.00 shipping and handling if purchased separately.
     No charge for CD if shipped with other items.)



I am paying by (check one):

___ Check (US banks only)  ____ Money Order (US $ only)

___ Mastercard  ___ VISA

If paying by Credit Card, complete the following.

Credit Card Number: _______________________________

Name on credit card: ______________________________

Expiration date: ________________

Signature: ________________________________________

Credit Card Billing Address if different from shipping address:
Street Address:___________________________________________________
City:_____________________________________________________________
State or Province:____________________  Country:__________________
Zip code or Country code:_____________  

Payment can be sent by surface mail or FAX to:

Creative Services Software, Inc.
503 W. State Street, Suite 4
Muscle Shoals, AL 35661
USA
Telephone: 256-381-6100
FAX: 256-381-6121

If you need additional information or have questions,
contact by email at the following address.
Email: sales@cssincorp.com