1  !"#$WS_FTP Professional Order Form ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Fax this form to: 617-676-5710 or mail to: Ipswitch, Inc., 81 Hartwell Avenue, Lexington, MA 02173 or call 1 (800) 793-4825 (U.S. and Canada) Check, money order, credit card, or company purchase order accepted. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Order Information All prices valid through 3/31/97 WS_FTP Professional Price/Unit Quantity Total 1 - 4 Units $37.50 ______ __________ 5 - 10 Units $35 .00 ______ __________ 10+ Units (See Ipswitch web site at www.ipswitch.com) Shipping/Handling (see below) ____________________ __________ TOTAL AMOUNT ($U.S.) __________ Windows (check one): __ 3.x, 95 or NT (Intel) / __ NT (Alpha) / __ NT (PowerPC) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Payment and Shipping Information Name: ________________________________________________________________ Title: _________________________________________________________________ Company: _____________________________________________________________ Address: _______________________________________________________________ City: ____________________________________ State/Province: ____________ Zip/Postal Code: ________________________ Country: ____________________________ E-Mail Address: _______________________________________________________ Daytime Phone: _________________________ Fax: _____________________________ Payment: ___ MasterCard ___ VISA ___ Check ___ Money Order ___ P.O. Credit Card Number: _____________________________ Expiration Date:______________ Purchase Order Number (orders over $100 only): __________________________________ Signature (for credit card orders) : ______________________________ Date: __________ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Shipping and Handling Charges*: U.S. Canada International FedEx Priority............$19.00 U.S. Mail...................$ 6.50 U.S. Mail...................$13.00 FedEx Standard.........$16.00 FedEx Priority............$24.00 FedEx Priority............$32.00 FedEx 2 day..............$ 5.00 FedEx Standard.........$21.00 FedEx 2 day..............$20.00 * Add $5.00 per order for shipments to Alaska or Hawaii. For each additional unit ordered, add $1.00 (U.S./Canada) or $2.00 (other countries). Shipping charges are subject to change at any time. rmation Name: ________________________________________________________________ Title:wso kgMcP_T[zW SOAKz Aow s5owkgc_[W[SaOKz wsokgc _F[UWqSvOKz wsokgc_[WSO%Kz %5wEsvokgc_[W>SaOeJ eiworrnie a_[W>SaOeJxvsMszs|ss qn?nAnqllllDlFlkl<<<<<<kmyy y-v/vwtyttt ttYt[tttttDtFt<<<<FyyyyEyGyyyyy>y@yayyyM y y y y y< yyyyEyGyyyyy>y@yayyyM y y y y y<f=/@8!898(U.S. and Canada) Chec% & ard, or company purchase order accepted. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Order Information All prices valid through 3/31/97 WS_FTP Professional Price/Unit Quantity Total 1 - 4 Units $ Arial_ __________ 5 - 10 Units $35 .00 ______ __________ 10+ Units (See Ipswitch web site at www.ipswitch.com