International Channels Order Form

Service Database Markets Record Format Report Clients I+I Profile Sample Request Order Form

InterInfo/Ideas + Information

Hilltop Business Center
South Hampton NH 03827-3509 USA

(603) 394-7600

(603) 505-4892 (Fax)

sales@interinfo.com

INTERNATIONAL IT CHANNELSINFO SERVICE (IICS)

IT GLOBAL GUIDE (ITG2) AD

ORDER FORM

Please enter my organization as a subscriber at the special CeBIT/Charter rates indicated below.

I agree that the information provided will only be used within my organization.

Name:

Title:

Organization:

Address:

City/Postal Code:

Country:

Phone:

Fax:

eMail:

See Order Box Below --

INTERNATIONAL IT CHANNELSINFO SERVICE (IICS)* -- $500

IT GLOBAL GUIDE AD (ITG2) -- $500

* -- Includes International IT CHANNELSINFO DATABASE (IICD) on CD with semi-annual update; CHANNELSINFO.COM Internet access 1 Year; eMail/Phone/Fax INQUIRY on resellers/markets of interest 1 Year

Enter IICS and/or ITG2 in Box Below

(Charter rates until 30 June 2012 - Regular rates - $750)

SELECT DATABASE FORMAT : (On CD ROM)
ACCESS
ACT
ASCII
Excel
FileMakerPro
Other

_______________________________________________________________

SELECT PAYMENT METHOD:

- Check
- Wire Transfer
- PayPal
- Bill Us -- PO#
- Amex/Mastercard/Visa/Discover (We will contact you for Name on card/Card #/Expiration Date)

Name:
Title:
Organization:
Address:
City/Postal Code:
Country:
Phone:
Fax:
eMail: