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6.7.9.1.4 Irie Pascal (Windows Edition) Euro Order Form

No. UsersUnit PriceQuantityAmount
    1    59.95_____________________
    5   249.95_____________________
   10   449.95_____________________
   20   849.95_____________________
   40 1,499.95_____________________
  100 2,499.95_____________________
Shipping
& Handling     5.00_____________
TOTAL_____________

[  ] Check/Money Order enclosed

Name:_______________________________________________________

Address:____________________________________________________

City/State/Province:________________________________________

Country/Postal Code:________________________________________

Telephone:_______________________________________ [optional]

Email Address:___________________________________ [optional]

How did you hear about Irie Pascal?_________________________

_________________________________________________ [optional]

[  ] Tick this box to join the Irie Pascal mailing list.

Please do not send cash. Make checks or money orders payable to Irie Tools. All prices are quoted in Euros and are guaranteed until March 31, 2004. Please allow two to four weeks for delivery. If you fill in your email address you will be notified by email when your order is shipped.

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