			Purchase order
			==============

Please send me ___ copies of POTP(tm) Secure FTP at $____ each.

For information on multi-user license fees, please write to:
sales@elementrix.co.il 
or call: 1-212-888-8879
or send fax to : 1-212-935-3882  


     Name: ______________________________________________

(Company): ______________________________________________

  Address: ______________________________________________

           ______________________________________________

     City: ______________________________________________

    State: _____________     

      ZIP: _____________

 Country: _____________

Telephone: _________________________  

      FAX: _________________________

Shipping & Handling (Postal) US & Canada $5.00 per item
Outside US & Canada $10.00 per item

TOTAL ENCLOSED US FUNDS  US$________

MODE OF PAYMENT:

Check Enclosed _____________

MasterCard __ or VISA __ or American Express __ or Diners Club International


              Total $US ___________

        Expiration Date ______________

            Card Number ____________________________________

Card Holder's Signature ____________________________________



In USA and CANADA                             Elsewhere
=================                             =========
Fax to: 1-212-935-3882                        Fax to: +972-4-550356

or                    
e-mail to: sales@elementrix.co.il



You may  FAX, or Email the above order to Elementrix.

