User`s guide

29
>Order Form
If an ATI Authorized Reseller is not in your local area,
please contact ATI directly to place your order.
For ordering assistance, please see the inside front cover.
QUANTITY ITEM
# PRODUCT DESCRIPTION PRICE TOTAL
BILL TO:
NAME
ORGANIZATION
STREET
CITY STATE/
PROVINCE
ZIP/POSTAL CODE COUNTRY
DAY TELEPHONE FAX
SHIP TO:
NAME
ORGANIZATION
STREET
CITY STATE/
PROVINCE
ZIP/POSTAL CODE COUNTRY
DAY TELEPHONE FAX
*If you are ordering directly from Assistive Technology, Inc. and live in a state where one of our
representatives is based (AL, CA, FL, MA, MD, MI, MN, NC, PA, TX, VA, WI), please enter your coun-
ty here so we can assess your correct local tax. Purchases made through any of our Resellers are
subject to local taxes.
PAYMENT METHOD
CHECK #
PURCHASE ORDER #
PLEASE ATTACH
CREDIT CARD
VISA MASTER
CARD
ACCOUNT NUMBER EXP DATE
NAME SIGNATURE
SUBTOTAL
COUNTY & STATE*
SHIPPING & HANDLING
TOTAL
Area 1: Continental United States
Area 2: Alaska, Hawaii, Canada
Call for International and rush rates.
Please allow 2–6 weeks for delivery.
Organizations with a tax-exempt number should attach a copy of their certificate to their order.
Product prices, specifications, bundle and kit contents and availability are subject to change.
We strive for accuracy, but reserve the right to correct pricing errors.
SHIPPING & HANDLING
ORDER VALUE AREA
1 AREA 2
$1–$50 $5 $10
$51–$99 $10 $20
$100–$699 $15 $30
$700–$1,499 $20 $40
$1,500–$2,499 $25 $50
$2,500–$3,999 $35 $70
$4,000–$4,999 $50 $100
$5,000 and up 1.25% 2.25%
Mercury II, MiniMerc, LinkCLASSIC, LinkPLUS, L*E*O, EvaluWare, and the Assistive Technology, Inc.
logo are trademarks of Assistive Technology, Inc. All other trademarks
are owned by their respective companies.
© 2005 Assistive Technology, Inc. CAT1005
333 Elm Street, Dedham, MA 02026
800.793.9227 • fax [phone]
www.assistivetech.com
[e-mail]
Assistive Technology, Inc. 1.800.793.9227 www.assistivetech.com
ORDER FORM