Printable Order Form

To order by mail or fax, print this order form, complete by printing or typing in required information, and mail or fax with payment information.

Mailing Address: TaskWare, 18, allee des Lilas  92150 SURESNES FRANCE
Fax: +33 1 47 72 75 25 (from US, dial  011 33 1 47 72 75 25) or email to order@wintask.com

SHIP TO INFORMATION
Company Name:
 ________________________________
Contact Name:
 ________________________________
Contact Phone:
 ________________________________
Address:
 ________________________________
Contact FAX:
 ________________________________
Town and Country:
 ________________________________
Contact E-mail:
 ________________________________

ORDER INFORMATION
Item
Quantity
Unit Cost
Total
WinTask
______
X $249.00
$________
WinTask Lite
______
 X $99.00
$________
Other
______
  
$________
Media and Shipping Charges  
[ ] Electronic Copy via e-mail FREE
$ _______
[ ] CD-ROM: $40.00
Total: $ _______
For EU customers, your VAT number:
 
 
 
 

PAYMENT INFORMATION
[ ] Check or Money Order
[ ] Bank Transfer of Funds
Bank name and address:
UBP    22 rue des Bourets
92150 Suresnes France
Swift code :
LUBPFRPP
IBAN  number :
FR76 3093 8000460013518000 168
[ ] Visa
 [ ] Master card
[ ] American Express
Credit Card Number:
 ___________________________
Expiration Date:
___________________________
Security Code (3 digits):
 ___________________________