Purchase Orders
Purchase orders (net 30 days) are accepted from government and accredited
educational institutions and major corporations, provided that they are
submitted on purchase order forms with a purchase order number. Final payments must be made in US
dollars drawn on a US bank. Please be sure to provide the order form below
with all orders.
Purchase orders can be sent to:
Mailing Address:
Respondus, Inc.
8201 164th Ave NE, Suite 200
P.O. Box 3247
Redmond, WA 98052
Fax: 425-881-3329
E-mail: sales@respondus.com (send as a PDF)
Checks
Check payments must be in US dollars drawn on a US bank, or you can send
international money orders in US dollars. Please be sure to provide the
order form below with all orders. Mail to: Respondus, Inc., 8201 164th Ave NE, Suite 200, P.O. Box 3247, Redmond, WA 98052.
Indicate how many copies of Respondus are being purchased:
| _____ | Respondus Single-user license(s) |
@ $149 each | = ________ |
| Washington state residents add sales tax (9%) | + ________ |
| Total Payment | ________ |
Payment Information:
Please use large and legible hand-writing
[ ] Check # ___________
[ ] Purchase Order # ______________
[ ] Credit Card:
[ ] MasterCard [ ] VISA [ ] AMEX [ ] Discover
Please use large and legible hand-writing
Credit Card #: ______________________________________
Expiration Date: _______________
Today's Date: ______________
Name on Card: _____________________________
Cardholder E-mail Address: _____________________________
Signature: _____________________________
Send To Information:
| Name: | ______________________________________ |
| Institution: | ______________________________________ |
| Address: | ______________________________________
______________________________________ |
| City, State/Prov: | ______________________________________ |
| Zip/Postal: | ______________________________________ |
| Country: | ______________________________________ |
| Day Phone: | ______________________________________ |
| E-mail: | ______________________________________ |
| Fax: | ______________________________________ |
How do you want your Respondus Activation Password(s) sent to you? (check one)
[ ] E-mail [ ] Fax
