Professional Documents
Culture Documents
ACQUISITION AUTHORITY
Name
Title
Organization
Address
City/State/Zip
Phone
Fax
Email
Signature
Date
LICENSING OPTION
P AYMENT
SHIPPING
Please ship ISLAB2000 to the following individual (if same as
licensee, write same in the name line):
Name
Title
Organization
Shipping Address
Payment method
Check (payable to ARA, Inc., ERES Division)
Money order (payable to ARA, Inc., ERES Division)
Credit card (MasterCard/VISA only)
Credit card number
Expiration date
Total
1. Software fee:
2. International shipping costs:
3. Subtotal (line 1 + 2):
4. Sales tax (7.50% of line 5):
(Illinois organizations only)
5. Total cost (line 3 + 4):