Ordering

Please complete the form below.
Print the completed form.
Fax to our offices at +1 905 628 1364

Enter the quantities for the product(s) you are ordering in the fields provided.

Quantity	Description	USD Unit Cost	USD Total
	MIDUSS 98 latest version, CD media, User manual	595.00

	MIDUSS 98 Educational, latest version, CD media, User manual	395.00

	Upgrade ver 4.71 to latest MIDUSS 98, CD media, User manual	395.00

	Upgrade ver 4.71 to latest MIDUSS 98 Educational, CD media, User manual	295.00

	*** Additional MIDUSS 98 license, no CD, User manual as PDF file on CD	100.00

	*** Additional MIDUSS 98 Educational license, no CD, User manual as PDF file on CD	75.00

	MIDUSS 98 User manual, 350 pages, soft cover	20.00

	Unlimited 12 months upgrade support from our web site	99.00

	Delivery

		Total:

	PST 8% (Ontario only):

	GST 7% (Canada only):

	Grand Total:

Fill in all your contact information.

Name:
Organization:
Address line 1:
Address line 2:
Address line 3:
City
Province / State:
Country:
Telephone
Fax:
Email:

Complete the Site Code field.

Site code:
Site code:
Site code:
Site code:

The Site Code is the unique fingerprint of the computer where MIDUSS is installed. This Site Code is used by us to generate a Keycode that allows full use of the software. If you have not yet installed MIDUSS, we will organize providing the Site Code and Keycode at a later time.

Select the shipping method:

	Serice and destination originating from Canada.	USD Price
	FedEx to International - 1 day	40.00
	FedEx to USA - 1 day	30.00
	FedEx to USA - 2 day	25.00
	FedEx to Canada - 1 day	20.00
	Air Mail to International - 10 day	20.00
	Air Mail to USA - 5 day	15.00
	Air Mail to Canada - 3 day	10.00
	No physical delivery. Send keycode by email.	NIL

Select method of payment:


Card Number*		Purchase Order Number**

Expiry (MMYY) example: December 2004 is "1204"		Cheque Number

Name on card

* Do not submit this form over the internet if you are paying with a credit card. The connection is not secure. We are presently developing a secure payment system. ** We accept Purchase Orders but reserve the right to issue temporary access Keycodes until full payment is received.		*** You can purchase additional licenses for your site for a very low cost but they must be purchased at the time of your initial full price license purchase. All extra MIDUSS licenses are for use at the same site. You cannot order additional licenses for other office locations. You cannot order additional low price licenses at a later date.

Alternative shipping address if applicable:

Your comments:

Please Note:
Orders are processed during business hours
M-F 9am-5pm EST (New York Time) with the exception of Holidays.

Electronic Delivery:
Upon Receipt of your order we will send you a custom Serial Number Keycode that is based on your Site Code provided above. If you did not provide the Site Code on this form you can submit the Site Code at your convenience to support@alanasmith.com.

Please fax to our offices at +1 905 628 1364

Thank you for your order!

Only press Submit if you are ordering with a
Purchase Order number. If paying with a Credit
Card please print and fax.