Nexus Terminal License Purchase Order
Complete the order form, print it and send it by post, fax or email to Nexus Integration

First Name:    Last Name:   
E-mail:  
Company:  
Address:   
City:    Province:   
Postal
code: 
  Country:   
Phone Number:    Fax:   



Nexus Terminal License:

    Copy / copies    -    each    
  Maintenance support ($10 plus 10% of the license fee)  
  Purchase total (US dollars):



Method of payment:
Company check included
Send an invoice for payment by check or bank wire transfer. PO

Payment by credit card only available online at www.nexit.com (secure connection to RegNow).



Signature: ____________________________ Date: _____________________



Nexus Integration, Vestlia 177, N-1453 Bjørnemyr, Norway
Fax: +47 850 32 120