Fax Order Form for PlanBee

Fax Order Form for PlanBee(#93016689571)
Ship-To Name & Address:

First/Middle Name:	Last Name:
Company name:
Address line 1:
Address line 2:
City:	State/Province --U.S. & Canada only:
Zip, Country:	Phone:	Fax:
Your email address:
Credit card number (MC, Visa, Amex, Discover, Switch, Delta, Eurocard, Diner's):	Expiration- Month/Year: Issue Number (Switch) Start Date (Diner's):

Credit Card Holder's Name & Address for verification: Do NOT enter the BANK's name or address in the fields below. Enter the address where the cardholder receives the statements. (Only fill out the spaces below if the credit card holder's name or address is DIFFERENT from the Ship-To name and address entered in the spaces above.)

Name on the card:	Company name:
Address line 1:
Address line 2:
City:	State/Province:	Zip, Country:

Order Details

Item		Price	Number	Subtotal
Single user		$29.98
Six user package		$129.98
Twenty user package		$329.98
Delivery methods and charges
Electronic Delivery: Keycode and Download link emailed		0
CD mailed with printable manual on the CD. Code CD4		$10.00
Disk mailed with printed manual		$20.00
Disk and printed manual via Express Courier		$50.00
Fax Handling Fee		$3.00	1	$3.00
Total Order Amount in US Dollars
Card holder will pay card issuer above amount pursuant to cardholder agreement	Signature: __________________________________

To order by fax using a credit card, please print out this document, complete it and fax to Soft Shop at one of the numbers below. All are toll free unless marked with a *. If your country is not listed please fax to the USA number +1(978) 336-0331
Australia 1800 013971 Belgium 0707 03334 * Finland 0925 360011 * France 0800 917034 Germany 0800 1808295 Sweden 0207 94125	Ireland 1800 509147 Italy 800 781703 Netherlands 0208 845094 * New Zealand 0508 555300 Portugal 800 844030 Canada (866)723-3438	Spain 900 95 8968 Switzerland 0800 835132 UK dial 01297 553366 * USA (866) 219 9380 (toll free or (978) 336-0331)