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 ($500)  
  Purchase total (US dollars): $ 


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

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


Signature: ____________________________ Date: _____________________



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