Amzi! Order Form
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INSTRUCTIONS

All Amzi! products and updates can be downloaded from our web site,
and are unlocked by entering the registration information we e-mail 
to you.

We accept MasterCard, Visa, Discover, American Express, purchase 
orders (from education, government, D&B-listed companies), wire
transfers and checks or money orders in U.S. dollars drawn on a 
U.S. or Canadian bank.

(Contact Us for Source Code Licenses)

For Immediate Shipment Visit www.amzi.com/download to purchase from
our on-line store,
    or fax:       718 / 732-2506
	or call:      828 / 350-0350
	or e-mail:    www.amzi.com on Internet

Or, Mail to--
	Amzi! inc.
	47 Redwood Road
	Asheville, NC 28804 U.S.A.


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Bill To:                              Ship To (if different):
Name (first last):                    Name (first last):

Organization:                         Organization:

Full Mailing Address:                 Full Mailing Address:




Country:                              Country:

Phone:

FAX:

E-Mail (required):

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 #  Item                                           Price Each    Total
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   Amzi! Prolog+Logic Server, Student Edition           US$ 49  ________
   Windows Operating System
   Includes 1st year maintenance
   Enter quantity:  __ Windows   __ Linux 

   Amzi! Prolog+Logic Server, Developer Edition        US$ 499  ________
   Includes 1st year maintenance
   Enter quantity:  __ Windows   __ Linux

   Amzi! Prolog+Logic Server, Professional License   US$ 1,499  ________
   Includes 1st year maintenance
   Enter quantity:  __ Windows   __ Linux   __ Solaris

__ Amzi! Prolog+Logic Server, Student LAN              US$ 149  ________
   Up to 10 Users on One Windows LAN
   Includes 1st year maintenance

__ Amzi! Prolog+Logic Server, Student LAN              US$ 299  ________
   Up to 25 Users on One Windows LAN
   Includes 1st year maintenance

__ Amzi! Prolog+Logic Server, Student LAN              US$ 499  ________
   Up to 50 Users on One Windows LAN
   Includes 1st year maintenance

__ Amzi! Prolog+Logic Server, Student LAN              US$ 699  ________
   Up to 100 Users on One Windows LAN
   Includes 1st year maintenance

__ Amzi! Prolog+Logic Server, Student LAN              US$ 999  ________
   Up to 255 Users on One Windows LAN
   Includes 1st year maintenance


                                                      SUB-TOTAL ________

                           U.S. Ohio Locations add 7% Sales Tax ________

              Shipping is via the Internet download and is free
     
                     TOTAL (all funds payable in U.S. $ please) ________

Payment Method:
__Check (drawn on a U.S. or Canadian bank)  __Wire Transfer
__MasterCard  __Visa   __American Express  __Discover  

Card Number:      ______________________________________________________

Expiration Date:  __________

Issuing Bank:     ______________________________________________________

Signature:        ______________________________________________________

Cardholder Name:  ______________________________________________________

Billing Address: (if different from "Bill To" address above)

                  ______________________________________________________

                  ______________________________________________________

Please tell us where you learned about us...

__an ad in_____________________         __an article in_________________
__a web site___________________         __a friend or associate
__mail from____________________         __other_________________________

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7 Nov 05