1st Atomic Time order form
==========================

Print this form (select "File|Print..."), and fill out all applicable 
fields below.

Fax this form to: 1-801-497-9456

Mail this form to: (checks payable to Emetrix)

Emetrix
ATTN: Sales
447 North 300 West Unit 2
Kaysville, UT 84037
USA

Name    _____________________________________________________

Address _____________________________________________________

        _____________________________________________________

City    _____________________________________________________

State   _____________________________________________________

ZipCode _____________________________________________________

Country _____________________________________________________

Phone   _____________________________________________________

Fax     _____________________________________________________

Email   _____________________________________________________

Credit Card Info: (if applicable)

 [ ] Visa [ ] MasterCard [ ] American Express [ ] Discover

Number  ___________________________________ Exp______________

Product Information:

Product Name    1st Atomic Time (Product ID: 409630)

Quantity        _____________________________________________

Price per copy  _____________________________________________

 [ ] Add a CD-ROM ($9.95 per copy)

Total           _____________________________________________

Single license of 1st Atomic Time is available for US $25

2-9 licenses - $21 per license

10-99 licenses - $17 per license

100-999 licenses - $10 per license

1000-4999 licenses - $5 per license

5000-9999 licenses - $2 per license

10000 and more licenses - $1 per license

Prices are subject to change without notice. The latest up-to-date information is available at http://www.atom-time.com/purchase/