Order Form

I Capture
Ordering by check:  To order by check send this order form and a check to:

Michael Caracena
4412 Pali Way
Boulder, Co
80301-3828

Payment must be in US dollars drawn on a US bank, or you can send international postal money
orders in US dollars.

Site licenses: A site license for I Capture entitles an organization to receive one copy of the
distribution package and duplicate the distribution disk for the specified number of copies.

I Capture is shipped on 3.5 inch disks only.

Prices include shipping by postal mail (airmail outside USA).
Prices guaranteed through December, 1996.

I Capture Single Copy    ____    copies at $35 each = ______

AVI Constructor Site License

2 to   9 computers: 	____ computers at $29 each = ______
10 to  24 computers: 	____ computers at $22 each = ______
25 to  49 computers: 	____ computers at $19 each = ______
50 to  99 computers: 	____ computers at $12 each = ______
100 to 199 computers: 	____ computers at $9  each = ______

Name: _______________________Date:___________

Company: _______________________________________ (optional)
Address: _______________________________________
City, State, Zip: _______________________________________
Country: _______________________________________
Day Phone: _________________Eve:__________________  (optional)
Electronic Mail address: ________________________________ (optional)

How did you hear about I Capture? __________________________
Comments:

