S-integrator Support Registration

S-integrator ^TM
Support Registration Form

To sign up for support:
	1. Print this page using browser's "Print" function
	2. Fill out the Registration Form
	3. Mail the Registration Form with a Check or Money Order to the address shown below
	4. You will be notified via email when your support registration has been activated

Contact Information:(please print clearly)
	Company:	____________________________________		Email Address:	____________________________________
	Name:	____________________________________		Phone Number:	____________________________________
	Address:	____________________________________
	City/State/Zip:	____________________________________

S-integrator Support Registration: (prices in U.S. $)
Item Name	Price	Number of Years	Total
S-integrator Support Level 1	$ 1,000.00/year	______	$ ______________
S-integrator Support Level 2	$ 5,000.00/year	______	$ ______________
S-integrator Support Level 3	$ 10,000.00/year	______	$ ______________
	Total:		$ ______________
	Total Enclosed:		U.S.$_______________

Payment Information:
Make check or money order payable to: Indigo Technology Partners, Inc.		Mail Registratiion Form with Payment to: Indigo Technology Partners, Inc. P. O. Box 100 Skillman, NJ 08558-1661

Thank you for your registration

Questions? email sales@s-integrator.org