StatusView Registration Fax Form
Print this page from your browser, fill it out and
fax it to: 919-386-0275. You may wish to adjust your browser font settings
before printing. If you prefer, you can provide this same information on a blank
sheet.
- Network Server type you are using (will use) with StatusView (check one only):
[ ] Windows 2000
[ ] Windows NT version: ______
[ ] Novell Netware version ______
[ ] Windows 98
[ ] Windows 95
[ ] Other _______________________
- Workstation type(s) you are using (will use) with StatusView (check all that apply):
[ ] Windows 2000
[ ] Windows NT version(s) _______________
[ ] Windows 98
[ ] Windows 95
[ ] Other(s) ________________________
- Registered License Level:
[ ] 20-user, $149.00 (+$8.94 tax in NC only)
[ ] 50-user, $249.00 (+$14.94 tax in NC only)
[ ] 100-user, $349.00 (+$20.94 tax in NC only)
[ ] 150-user, $449.00 (+$26.94 tax in NC only)
- Credit card information:
Card type: [ ]MasterCard
[ ]Visa
[ ]American Express
Card number: _________________________
Expires: ____________ (MM/YY)
Name on card: ____________________________
Signature: ____________________________
- Contact information - We must have a complete physical delivery address
to process your registration order (no post office boxes, please):
Name: ___________________________________
Company: ___________________________________
Address: ___________________________________
City,St Zip: ___________________________________
Phone: __________________ Fax: _______________
Email: ___________________________________
- Support contact - Your Registered License will entitle a designated support
contact person to receive product support for ninety (90) days following the
date on which your license is issued. Specify the name of the person who
will be the authorized support contact for StatusView, if different from the
name provided above:
Support Contact: ________________________________
- If you have not already downloaded StatusView, and would like to receive
StatusView software on disk, indicate so below. Note that a shipping and
handling charge will be added to your registration fee:
Note: Only 3.5" floppy disk media is available.
Choose 32-bit StatusView for Windows 95, 98, Windows NT & Windows 2000.
Choose 16-bit StatusView for Windows 3.1 & WFW 3.11.
[ ] Send me 32-bit StatusView only ($10.00 S & H)
[ ] Send me 16-bit StatusView only ($10.00 S & H)
[ ] Send me BOTH 32 and 16-bit StatusView ($15.00 S & H)
- Total your order:
$____________ Software License Fee
$____________ 6% Sales tax (in NC only)
$____________ Shipping & Handling (for media, if any)
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$____________ Total Charges
Fax this completed support request form to: 919-386-0275
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