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Siborg Systems Inc. Software Order Form

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Products Quantity Unit Cost (US$) Total Cost (US$)
   MicroTec
      Student *         
      Academic
      Professional **
   SibLin
      Student ***
      Academic
      Professional **
      

         * Number of nodes is limited to 600
         ** Please contact Siborg for additional pricing information
         *** Number of nodes is limited to 6000

 
  Shipping Address
 Name:
 Organization:
 Address:
 
 City:
 State:
 Zip:
 Phone:
 Country:
 Email:

Shipping and Handling
Canada & USA Overseas
   US $20.00 - Air Mail    US $30.00 - Air Mail
   US $50.00 - Express Mail    US $100.00 - Express Mail
Payment Options
Bank Wire Transfer

Royal Bank of Canada, Main Branch,70-74 King St.
South, Waterloo, Ontario N2J 3Z6 Canada
Ref. MicroTec Account No. 07682 003 400 100 4

  Transaction Date:   Reference No.

Cheque/Money Order Payable to Siborg Systems Inc.
 Amount $US  Purchase Order #  Date:

Credit Card
Visa Mastercard
  Card Number:   
  Cardholder Name:   
  Expiry date:      /