Gel Quant Pricing / Order Form

Gel Quantifier Image Analysis Software

To order Gel-Quant software, please complete the order form on this page, then print out and post / fax to:
AMPL Software Pty Ltd 3 McRae Place, Turramurra NSW 2074 AUSTRALIA	ABN: 32 002 781 811 Fax: (02) 9440 0271 Overseas Customers Fax: +61 2 9440 0271
We are unable to accept orders via email or telephone.

Qty	New Single User Copies	Price (incl GST) Australian Customers	Price (excl GST) New Zealand & Overseas Customers
	Gel-Quant Single User	$A935.00	$A850.00
FREIGHT:	Australian & New Zealand Customers = no charge. All other customers add A$45 shipping & handling.

Name:
Department:
Institution/Company:
Street:
Suburb:
State:		Postcode:
Country:
Phone:	Fax:
Email:
ORDER VALUE:	Australian Dollars$ (including freight if necessary)
METHOD OF PAYMENT
CHEQUE: Drawn on an Australian bank and payable to AMPL Software Pty Ltd.
PURCHASE ORDER: Purchase Order Number: Copy of Purchase Order must be attached. Payment by purchase order available to approved customers only.
CREDIT CARD: Visa Mastercard American Express
Card Number:
Card Expiry:
Cardholder's Name:
Cardholder's Signature:
All prices are in Australian dollars and are subject to change without notice.
Please fax to (02) 9440 0271 (overseas customers: +61 2 9440 0271) or post to: AMPL Software Pty Ltd, 3 McRae Place, Turramurra NSW 2074, Australia. Allow up to 14 days for delivery (usual delivery times are 2-3 working days).
January 2010