CheckMAN-tm Accept Checks by the Fax, Phone, & Email, + Much More!!

CheckMAN™ E Z ORDER FORM

Print This Form and Mail or Fax To :

Nelson Publications ~ 1600 Bryan Street, Ste B ~ Normal, IL 61761

Fax: 309.452.7035 (24 hours)

CYBERFIEDS

[X]	I would like to Order The Following

[ ]	CheckMAN Standard Demo	$5.00 (First Class Mail)
[ ]	CheckMAN Standard Edition	$34.95 ($29.95 + $5 Priority s/h)
[ ]	CheckMAN Professional Edition	$74.95 ($69.95 + $5 Priority s/h)
[ ]	CheckMAN Standard + 300 Checks	$54.95 ($29.95 + $20 + $5 Priority s/h)
[ ]	CheckMAN Professional + 300 Checks	$89.95 ($69.95 + $15 + $5 Priority s/h)
[ ]	EXPRESS Delivery CheckMAN Pro + 300 Checks	$99.95 ($69.95 + $15 + $15 Overnight s/h)

Please Ship to:

Address:________________________________________________________

City / State / Zip:_________________________________________________

Phone & Fax:____________________________________________________

I would like to Pay By:

[ ] Check [ ] Money Order [ ] Faxed Check [ ] Visa [ ] MasterCard

Name on card:______________________________________Amount: $__________

Billing Address:________________________________________________________

Get Your CheckMAN™ Today!!

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