APORIA V1.4c ORDER and REGISTRATION FORM _______ PRICING _______________________________________________________ Cost x Quantity = Total Registration w\ Disk and Printed Manual $50 x ______ = _______ Sub-Total ______ _______ New York Residents add 8 1/4% sales tax _______ Shipping & Handling: US, Canada Mexico add $5 Outside of North America add $10 _______ Total Enclosed _______ Terms: Checks must be drawn on a U.S. bank in U.S. funds. Purchase orders (net 30) accepted from major US corporations. No COD orders. Call for information on site licensing. _______ REGISTRATION INFORMATION ______________________________________ Name: ____________________________________ Date: _____________ Title: _____________________________________________________________ Company: _____________________________________________________________ Address: _____________________________________________________________ _____________________________________________________________ City: ___________________________ STATE: _______ ZIP: _________ Phone: __________________________________ VISA [ ] Master Card [ ] American Express [ ] Card Number: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Cardholder Signature: ____________________________ Exp Date: _________ _______________________________________________________________________ Comments or suggestions: ___________________________________________________________________ Mail To: NewTools, Inc. POB 3269 Church Street Station New York, NY. 10008-3269 (800) 395-1532