International
Fax Order Form

       Name:  
    Company: 
    Address: 
             
       City:  
State/Prov.:  Zip/Postal Code: 
    Country: 

      Email: 
      Phone:  
        Fax: 

Pendragon Forms 5.1: 0 1 2 3 4 5 @ $299.00 each (CD-ROM delivery req.).

Pendragon Forms 5.1: 0 1 2 3 4 5 @ $279.00 each (email delivery.).
Pendragon Forms 5.1 Upgrade: 0 1 2 3 4 5 @ $139.00 each (CD-ROM delivery req.).

Pendragon Forms 5.1 Upgrade: 0 1 2 3 4 5 @ $119.00 each (email delivery).
Pendragon Forms 5.1 Additional Licenses: 0 1 2 3 4 5 @ $70.00 each (email delivery)

Shipping Method: Global Priority Mail, $22 Global Priority Mail CANADA, $15 Other (US$)

Global Priority Mail is available these countries in Western Europe or Pacific

Please email: info@pendragonsoftware.com for a FedEd shipping rate quote.

Notes: ___________________________________________ 

Order Total (including shipping & handling): _________________
(You pay applicable customs duty & tariffs when merchandise arrives in the destination country)

Card Type: VISA MasterCard American Express
Credit Card Number: Exp. Date:

Signature _______________________________________

I agree not to re-export the Pendragon Forms software.

Signature _______________________________________ Date ____________