For
payment methods and instructions, see below.
For sales questions call 800-282-5361 or 303-546-7929 or email sales@medialab.com
Ship
To Address
Today's
Date: ____/____/_____
Name: ____________________________________________________________
Company: _________________________________________________________
Address: __________________________________________________________
City:___________ State:___ Country:______ Zip/Postal Code: _______
Phone: ( ) _________________ Fax: ( ) ______________________
E-Mail Address: __________________________________ (REQUIRED)
How did you hear about Media Lab? __________________________
Product
|
Download Price
|
|
Qty
|
( Mac/Win)
|
Ext.
Price
|
| PhotoWebber |
$129 |
|
|
|
|
| AlphaMania & Effector Sets I, II |
$199 |
|
|
|
|
| PhotoCaster |
$199 |
|
|
|
|
| PSD2FLA |
$ 89 |
|
|
|
|
BUNDLES (Bundles must be for the same Director SN
|
| AM/PC/ES1/ES2 |
$349 |
|
|
|
|
CROSS PLATFORM BUNDLES (One Mac and one Win Director SN)
|
| PhotoCaster |
$329 |
|
|
|
|
| AM/PC/ES1/ES2 |
$549 |
|
|
|
|
UPGRADES
|
| PC 3 Upgrade |
$ 79 |
|
|
|
|
Coupon #________________ Percent Off: ______%
Discount: _____
Subtotal: _____
Shipping: _____ Shipping Charges (Per Packaged Version) US $15, International
$50
Total : _____ US$
IMPORTANT - for all AlphaMania, PhotoCaster & Effector Sets
Last 10 Digits of Director S/N: ____________-_____________ MAC
Last 10 Digits of Director S/N: ____________-_____________ WIN
Director version: 5 __ 6 __ 7 __ 8 __ 8.5__(check one)
IMPORTANT - for all PSD2FLA purchases
Photoshop Serial Number: ____________________________________
Photoshop version: 4__ 5 __ 5.5__ 6 __ 7 __ (check one)
Platform: Win___ \ OSX____
PAYMENT METHOD
Mastercard __ Visa __ AMEX __ Wire Transfer ___ Check #_____ (Sorry,
no C.O.D. or credit terms)
To
order by credit card, fill out this form and fax it to 303-479-9217.
Cardholder Name (Please Print):_____________________________________
Card Number: ______________________________ Expiration Date: ____________
Cardholder Signature: __________________________________________
To
order by check, fill out this form and mail it with your check
made out to Media Lab, Inc.to:
Media
Lab, Inc.
2501 Lanyon Drive
Longmont, CO 80503
To
order by wire transfer, fill out this form and fax it to 303-485-9069.
For information on wiring money to Media Lab, email sales@medialab.com
or call 303-546-7929.
rev 9/15/02