Beam 2D ORDER FORM
Item 1:..................................................................... Quantity.................
Item 2:..................................................................... Quantity.................
Item 3:..................................................................... Quantity.................
Name..................................................................................................................
Company..............................................................................................................
..........................................................................................................................
Address..............................................................................................................
..........................................................................................................................
................................................................... Country.....................................
Telephone...........................................................................................................
Fax.....................................................................................................................
E-mail................................................................................................................
Beam II serial number (required for upgrade) ..............................................
Cheque enclosed __ Visa __ Master Card __ Amex __
Card Number............................................................
Expiry Date..............................................................
Amount................. Signature....................... Date..................................
s&h will be added if not included in the amount
Beam 2D order fax: +1-905-569-0045
Mail: ORAND Systems Inc., 3635 Belvedere Cres., Mississauga, ON L5L 3A5, Canada