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This order form should be completed, printed and mailed with your check (payable to "E. G. Collins") to:
E. G. Collins, 700 Division Street, Metairie, LA  70001   U.S.A
Fields marked with an asterisk * are required and must be completed.
Customer Information   Use the following fields to specify how you want product registered and where to ship. Be sure to double check your e-mail address since this will be used to transmit your Registration Code(s).
* First (MI) & Last Name  
Company Name  
* Register license in  
* Address (Suite/Apt)  
* City  
* State/Province  
* Zip/Postal Code  
* Country  
 Car Trak & Lender's ToolBox are sold in all countries listed.
 Other products are sold ONLY in countries marked with
 an asterisk ( * )
* Daytime Phone  
* E-mail Address  
Please double check your e-mail address as this will be used to transmit your Registration Code(s).
Order Information   Physical shipments (installation CD) are available ONLY to postal addresses in the U.S.A., Bahamas, Bermuda, Canada, Mexico, Puerto Rico, Virgin Islands (British), and Virgin Islands (U.S.)!
* Quantity / Product  
* Product  
Unit Price (each)  $  
Additional license(s)        @  $  per installation/user  =  $
Shipping/Handling  $     Ship only ONE set of installation disks or CD
Total Amount  $    *All Orders: Remit payment in US Dollars drawn on a US Bank
Other Information   The following information is optional but would be appreciated ...
it will help us plan future releases and enhancements/improvements to the software.
Where did you hear  
about this product?  
Your operating system  
IMPORTANT: Please use the evaluation period to ascertain that the product meets your particular needs before ordering ... all sales are final!   (If your order includes shipment of an installation CD and it proves to be defective it will be replaced.)
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