NetWanga tm Order Form  
This form is for payment by Checks and Money Orders.
You can also pay by Credit Card using this form.


ITEM                                         QUANTITY           TOTAL PRICE
            
NetWanga for Windows                         _________ X $ 9.99 ___________
NetWanga for Macintosh                       _________ X $ 9.99 ___________
NetWanga for Linux                           _________ X $12.99 ___________
NetWanga for Solaris                         _________ X $12.99 ___________
NetWanga for Mainframes/Minis/Supercomputers _________ X $12.99 ___________
NetWanga for Vintage Computers               _________ X $12.99 ___________

                                                  SUBTOTAL:    $___________

___________________________________________________________________________

                                       Shipping & Handling:

                               $4.00 per Order (US & Canada)   $       4.00
               Other countries, add $6.00 additional S&H fee   $       
																						
      California residents, add sales tax (8.25% X SUBTOTAL)   $

                                                     TOTAL:    $___________

___________________________________________________________________________

Method of Payment:

[ ] Check/Money Order enclosed including handling, for         $___________
    (Make check payable in US funds to: micro/future)

[ ] VISA/MasterCard/American Express/Discover                  $___________

Card Number_________________________________________Exp Date_______________

Your Three Digit Card Verification Number (on the back) ___________________

Signature__________________________________________________________________

Print Name_________________________________________________________________

Billing Address____________________________________________________________

Shipping Information

Name_______________________________________________________________________

Company____________________________________________________________________

Address____________________________________________________________________

City______________________________________________State____________________

PostalCode__________________________Country________________________________

Phone_______________________________Fax____________________________________

Email______________________________________________________________________

___________________________________________________________________________

Mail or Fax your order:

      By mail:   micro/future
                 PO Box 2202
                 Venice, CA 90294
                 USA
				 
      By fax:    1.310.281.8376
      (Credit Card Orders Only)


Allow 2 weeks for delivery.
All Sales Final.


You can reach us at sales@netwanga.com 
if you have questions about the progress of your order.
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