1st Clock order form ======================== Print this form (select "File|Print..."), and fill out all applicable fields below. Fax this form to: 1-801-497-9456 Mail this form to: (checks payable to Emetrix) Emetrix ATTN: Sales 447 North 300 West Unit 2 Kaysville, UT 84037 USA Name _____________________________________________________ Address _____________________________________________________ _____________________________________________________ City _____________________________________________________ State _____________________________________________________ ZipCode _____________________________________________________ Country _____________________________________________________ Phone _____________________________________________________ Fax _____________________________________________________ Email _____________________________________________________ Credit Card Info: (if applicable) [ ] Visa [ ] MasterCard [ ] American Express [ ] Discover Number ___________________________________ Exp______________ Product Information: Product Name 1st QuickLaunch (Product ID: 288019) Quantity _____________________________________________ Price per copy _____________________________________________ [ ] Add a CD-ROM ($9.95 per copy) Total _____________________________________________ Single license of 1st QuickLaunch is available for US $18.95 2-9 licenses - $15 per license 10-99 licenses - $12 per license 100-999 licenses - $9 per license 1000 and more licenses - $5 per license Prices are subject to change without notice. The latest up-to-date information is available at http://www.1stquicklaunch.com/purchase/