INIPATcher Registration and Order Form  CAFIP1.0
___________________________________________________
To place your order, fax us at (504) 626-1189 or send this form to:

DAMEWARE DEVELOPMENT
1024 Live Oak Loop
Mandeville, La.  70448
For credit orders see section: 
Credit card order information


Name:	________________________________________________________
Company Name:	________________________________________________________
Address:	________________________________________________________
	________________________________________________________
	________________________________________________________
	________________________________________________________
Phone: 	Day time:_______________________Eve:______________________
Electronic Mail:	_________________________


INIPATcher _____@ $10.00 ea	$________________________
Shipping and Handling	$ 3.00	$________________________
		
INIPATcher Site License		
2  	to 	5  	computers: _____	computers @ $10 each = ______________
6 	to 	10	computers: _____	computers @ $9  each = ______________
11  	to 	49	computers: _____	computers @ $6  each = ______________
50  	to 	99 	computers: _____	computers @ $5  each = ______________
100  	to 	199	computers: _____	computers @ $3  each = ______________
		(More than 199 copies are negotiable)
		
Total		$________________________
		
Please specify disk format:	5 1/4"_____	3 1/2"_____
PLEASE NOTE:  We accept cash, checks, money orders and COD's except
international.  We do not accept unsolicited POs or overseas checks not
drawn on American banks.  Overseas orders please include an additional
$5.00 USD for S & H.
CAFIP1.0
