GroupApps.com Order Form

To place an order, print and fax this form to:
(302) 348-4162
or mail this form to:
GroupApps.com, Inc.,110 Oneida Ave.
Croton-on-Hudson, NY 10520

1
Name: Email:
Title:
Company :
Office Phone: Fax:
Street: City : State: Zip:

Item Description	Part No.	Quantity	Unit Price	Extended Price
Dispatch Server License for Lotus Notes R5/6.x	DISP-R5/6-SVR	1	1	1
Dispatch Site License for Lotus Notes R5/6.x	DISP-R5/6-STE	1	1	1
Dispatch Server Annual Maintenance	DISP-SVM	1	1	1
Dispatch Site Annual Maintenance	DISP-STM	1	1	1
Dispatch Phone Support	DISP-SUP	1	1	1
SUBTOTAL:				1
NY Customers add SALES TAX:				1
Electronic Delivery (specify email address above)				N/C
Add $15 for Next Day Shipping:				1
TOTAL ORDER:				1

Payment Information:
GroupApps.com accepts the following forms of payment:

Corporate Check payable to "GroupApps.com, Inc."
Purchase Order with payment terms of "Net 30 Days"
American Express

If paying by American Express, please provide the following information:

Money-back Guarantee:
If you are not completely satisfied with your purchase, simply return the product within 60 days for a full refund.