Green Mountain Computing Systems, Inc. ORDER FORM
P.O. Box 275, 1070 W. Main St., Richmond, VT 05477 Fax: (802) 434-5071
Name _________________________________________________________________
Address ______________________________________________________________
Address ______________________________________________________________
City ______________________________ State ____________________________
Zip Code ____________________ Country ________________________________
E-mail Address _______________________________________________________
Telephone # __________________________________________________________
Item Description Unit Price Quantity Item Total
DirectVHDL
Windows US $135 _______ _________
Windows, STUDENT Price** US $75 _______ _________
SUBTOTAL _________
Total Shipping
SHIPPING METHOD Unit Price Quantity Total
o E-mail attachment US $0 _______ _________
o Standard US $6 _______ _________
o Federal Express Overnight US $12 _______ _________
(Continental U.S. only)
TOTAL CHARGES
TOTAL _________
PAYMENT METHOD:
[ ] Check or Money Order Enclosed
[ ] Charge to the following: [ ] Visa [ ] MasterCard [ ] Amex
Card Number: ___________________________ Expiration: ___/___
Name on Card: ___________________________ Signature: _____________________
Card holder address: _____________________________________________________
(If different)
* Prices are subject to change without notice.
** Please include a photocopy of your VALID student ID, to receive student
pricing. One copy limit per student.