FAX or Mail Order     

Please print and fill out this form and fax to us or mail to this address:
Belltech Systems, Attn: Sales
22525 SE 64th Place, Suite 233
Issaquah, WA 98027,USA
Fax: (206) 274-4869
http://www.belltechsystems.com

Your Purchase Information:

Your Name__________________________
Your Email__________________________
Company Name(optional)__________________________
Address________________________
     ________________________
City___________________________
State___________________________
Zip___________________________
Country___________________________
Phone # _________________________________

Order Details

    Qty. Product Name CD-ROM   Price
  ____  ____________________  Yes/No  __________
  ____  ____________________  Yes/No  __________
  ____  ____________________  Yes/No  __________
  ____  ____________________  Yes/No  __________
  ____  ____________________  Yes/No  __________

Attach your Money Order, payable to Belltech Systems, or provide your payment information below.

Payment Information (if paying by credit card)
Name on Credit Card: ________________________________
Card type (circle one): Visa, Mastercard, American, Express, Discover
Card Number: ___________________________
Card Expiry Date( month/year ) : ______ / _____
Total amount to be charged:______________
Card holder's signature : ________________

Pricing Guidelines for PO

  • Business Card Designer Pro 5-user license: US $149.95
  • Business Card Designer Pro 1-user commercial license: US $99.95
  • Small Business Publisher 5-user user license: US $199.95
  • Greeting Card Designer 5-user user license: US $169.95
  • Greeting Card Designer 1-user Commercial license: US $199.95
  • Label Maker With Data Merge 5-user user license: US $199.95
  • CaptureXT Screen Capture 5-user user license: US $127.50
  • Software in CD-ROM: Please add an additional US $12.95 + $2(shipping) for each CD
  • Volume discount may be available from time to time. Please contact us for more info.

    Shipping Note: Shipping is by USPS 1st class ground. For USPS priority delivery please add $10 more.

    Signature:_________________
    Full Name:__________________________
    Date:____________________