Order Form

Order Form

Please fill out all information on this form, print it out, and sign it.
Your check or money order should be made out in US dollars
and drawn on a US bank, made out to Datasqueeze Software. Please, no cash.
Send the form, together with the check, money order, or institutional purchase order to:
Datasqueeze Software
PMB 252
303 West Lancaster Ave.
Wayne, PA 19087-3938
Your registration key will be sent to you by email, typically 7 days after we receive your order.

Organization:

(required for Academic version)

Department:

Personal Name:

(required)

Family Name:

(required)

Street Address
or P.O. Box:

(required)

City:

(required)

Postal Code:

(required)

State:

(U.S. only)

Country:

(required)

Phone:

Fax:

Email:

(required)

Order:

	Datasqueeze 2.1 (100 US$)
	Datasqueeze 2.1, Academic Version (50 US$) By purchasing this item I affirm that I am a full-time student, teacher, or staff member in the educational institution (elementary, high school, university) listed above.

Signature:

(required)

Institutional Purchase Orders: Must emanate from major, recognized institution (e.g., university or company), must be signed by an authorized official of that institution, and must contain a valid purchase order number and bill-to address.