GSL Galactic Consulting home page

Software Order Form

GSL Galactic Consulting

Full refund within 30 days if not completely satisfied.

Instructions: fill out this form completely and click the button at the bottom of the form; this will pre-register your software. Then, because prepayment is required before the software can be sent to you, print this form. Fax to us the completed form containing your credit card information, or mail the form to us along with your check.

Selection

QP-SEP Illustrator ($150)

SIMPLE Illustrator^® ($150)

Both programs ($250).

Optional: add $15 for next-day delivery, or we can charge the next-day delivery expenses to your Federal Express or Airborne account number.

(To do so, enter your account number here: and indicate whether it is
Federal Express, or
Airborne).

All items not shipped next-day delivery are shipped 2-3 day Priority Mail.

Please enter the total here: $

Shipping Preference

How would you like to have your order shipped?

E-mail me the program file (with operating instructions) - the fastest way! My email address is:

Priority mail

Federal Express (additional $15 charge)

If by e-mail the software will also be mailed to you in the form of a CD-ROM.

Payment

Check. (Print and mail this form to the address shown below. Make check payable to "Gary Lesser.")

VISA (Print and fax or mail this form to the address shown below.)

MasterCard (Print and fax or mail this form to the address shown below.)

American Express (Print and fax or mail this form to the address shown below.)

Debit Card (Visa or Mastercard) (Print and fax or mail this form to the address shown below.)

Card number: ______________________________

Expiration date (mm/yy): ___________________

Billing address (P.O. box or street) for your credit or debit card:

Billing address (city, state and zip) for your credit or debit card:

Registered User Information (required)

Registered User's name:

Mailing address for renewal notices and land mail (PO Box or street):

City, state, zip:

Telephone number:

Purchaser Information (required)

Purchaser's name:
Organization (if applicable):
Telephone number:
Fax number:

Click on the button below to send your order. In 5 to 30 seconds, you should receive a confirmation screen.

Thanks for your order!

Be sure to include an e-mail address that can accept an attached file, if you've requested email delivery.
Your privacy is important to us! Customer information will not be sold by GSL Galactic Consulting or otherwise disseminated.

Gary S. Lesser, J.D.
GSL Galactic Consulting
944 Stockton Street
Indianapolis, IN 46260-4925

Telephone (317) 317-254-0385
Facsimile (317) 317-254-0386
E-mail: qpsep@aol.com

GSL Galactic Consulting home page

	E-mail me the program file (with operating instructions) - the fastest way! My email address is:
	Priority mail
	Federal Express (additional $15 charge)

	Check. (Print and mail this form to the address shown below. Make check payable to "Gary Lesser.")
	VISA (Print and fax or mail this form to the address shown below.)
	MasterCard (Print and fax or mail this form to the address shown below.)
	American Express (Print and fax or mail this form to the address shown below.)
	Debit Card (Visa or Mastercard) (Print and fax or mail this form to the address shown below.)
Card number:	______________________________
Expiration date (mm/yy):	___________________
Billing address (P.O. box or street) for your credit or debit card:
Billing address (city, state and zip) for your credit or debit card:

Registered User's name:
Mailing address for renewal notices and land mail (PO Box or street):
City, state, zip:
Telephone number: