****** ORDER FORM -- MY WALK SOFTWARE ******
Please enter your information, then print and mail completed order form with check or money order for total amount due to:
Backroads Data; P.O. Box 238; Baldwin City, KS 66006-0238
REQUIRED INFORMATION
Ordered By:
(Name)
Organization:
(if applicable)
Ship Address:
City:
State:
ZIP:
Phone:
REQUESTED INFORMATION
Email Address:
How did you hear about My Walk Software?
Additional Comments:
PRICE CHART
Quantity Ordered:
1 to 4 programs
5 to 9 programs
10 or more programs
Price Each:
$29.95 ea.
$25.95 ea.
$20.95 ea.
Shipping/Handling Charge - U.S.A.:
$ 3.00
$ 6.00
$ 9.00
My Walk Software
Order
(all amounts are U.S. Dollars)
Quantity:
at
29.95
25.95
20.95
each
Total Price:
Shipping and Handling:
(see chart above)
3.00
6.00
9.00
Total Due:
Optional - if you have an order code, enter it here -
Order Code:
THANK YOU FOR YOUR ORDER!
© Backroads Data 1999-2001. Updated 10-11-02