BETTERVIEW ORDER REQUEST FORM Shipping / Billing Information: Name:_____________________________________________ Title:______________________________________________ Company:___________________________________________ StreetAddress:_________________________________________ _____________________________________________________ City:______________________ State/Prov.:_________________ Country:___________________ Postal Code:______________ Phone:_____________________ Fax:____________________ Email:____________________ ------------------------------------------------------------------------------------------------------ ORDER ITEMS: VI Title/ License Options:(circle one) LV Touchscreen Toolkit (Alphanumeric Keypad and Keyboard VIs) a) 1 user ($50 US) b) 2-20 users ($129 US) c) Greater than 20 users (please call or contact via email) LV Operator Security System (OSS) Toolkit a) 1 user ($89 US) b) 2-20 users ($119 US) c) Greater than 20 users (please call or contact via email) LV Color Picker Pro - Single User only ($30 US) Mathematica Link for LabVIEW a) Platform: Windows or MacOS 9.x (circle one) b) Format (please circle one): - Electronic Distribution - $425 US - Physical package (includes installation CD-ROM and 200-page manual) - $495 US License Subtotal:____________ Less Authorized Discount (if applicable): ______________ Discount Authorization Code: ________________ ------------------------------------------------------------------------------------------------------ Shipping Option: (circle one) a) Internet Download (password emailed to you) - $ 0.00 b) Floppy Disk or CD via regular mail (US & CANADA only) - $ 10.00 US c) Floppy Disk or CD via priority mail (US & CANADA only) - $20.00 US d) Floppy Disk or CD via Regular FedEx (US & CANADA only) - $25.00 US e) Floppy Disk or CD via Overnight FedEx (US & CANADA only)- $40.00 US f) Foreign Order Shipping (Please contact us by email: info@bettervi.com) Shipping Subtotal:__________________ Sales Tax: CANADIAN ORDERS ONLY Canadian orders add 7% (GST) British Columbia Residents add 14% (PST&GST) Total Sales Tax ___________ Invoice Total:____________________________ Payment Method: (circle one) 1) Check or International Money Order Enclosed 2) Company Purchase Order: Credit Check Information: Contact Name:____________________________ Fax Number: ____________________________ 3) VISA Card Credit Card No:____________________________________ Exp. Date:______ Name on the card:__________________________________________________ Please fill out this form and fax or mail it to : BetterVIEW Consulting 13531 Ð 19th Avenue Surrey, BC Canada V4A 6B3 Tel: (604) 535 2456 Fax: (604) 535 2487 Note: Make cheque or money orders payable to: "BetterVIEW Consulting". Thank you for this order!