PROM LoanMaker^® 23A for Palm Handhelds Order Form

To order this item, please download the demonstration program and install it on each Palm Handheld. 

Then go to the Register screen on each device and copy the Product ID Number to 

this order form.  (Use additional sheets if necessary.)

                     Product ID Number

#1______________________________    _____________________________

#2______________________________    _____________________________

#3______________________________    _____________________________

#4______________________________    _____________________________

#5______________________________    _____________________________

Please enter my order for the following items:

[  ]  I have enclosed a check with this order form for the total amount due.

[  ]  Please charge the total amount due to my credit card as shown below:

Card Type:  [  ] American Express    [  ] MasterCard     [  ] Visa

Card Number ______ ______ ______ ______   Expires ____ / ____ 

Name on card __________________________________________

Billing address __________________________________________

______________________________________________________

Signature ______________________________________________

If you have any questions, email us at the address below or call +1 800 843 7766.
28 Oct 2007