****************** BugTracker Server 3 Order Form ****************** Your Name ...... : ------------------------------------------------- Your Company ... : ------------------------------------------------- Phone Number ... : ------------------------------------------------- Fax Number ..... : ------------------------------------------------- Email Address .. : ------------------------------------------------- How did you learn ( ) Google ( ) Yahoo ( ) download.com ( ) Friends about Avensoft? : ( ) Other: -------------------------------------------------------------------- Product Price Qty. Total -------------------------------------------------------------------- BugTracker Server 2-User Download US$ 400 x = -------------------------------------------------------------------- BugTracker Server 10-User Download US$ 800 x = -------------------------------------------------------------------- BugTracker Server 50-User Download US$ 1400 x = -------------------------------------------------------------------- BugTracker Server Unlimited-User Download US$ 2000 x = -------------------------------------------------------------------- Annual Support US$ 200 x = -------------------------------------------------------------------- Consulting Service 5 Hours US$ 350 x = -------------------------------------------------------------------- Total = ( ) Pay by Credit Card. Please fax this form to +1 888 476 6276. *************** Also send an email to sales5@avensoft.com so that we can contact you in case your fax is not readable. Credit Card : ( ) AMEX ( ) MasterCard ( ) VISA Card Number : ------------------------------------------------- Expiration : Date ------------------------------------------------- Name On Card : ------------------------------------------------- Billing : Address ------------------------------------------------- ------------------------------------------------- ------------------------------------------------- Signature : ------------------------------------------------- ( ) Pay by checks drawn on U.S. banks, international traveler's checks or money orders. Please mail this form with payment to: Avensoft 1423 Copper Mountain Drive Diamond Bar, CA 91765 United States ( ) Pay by Fund Transfer. E-mail this form to sales3@avensoft.com. ********************************************************************