Order Form:

 

Name and Contact Information:
First Name:
Last Name:
Email:
Street:
City:
Province/State:
Postal/Zip Code:
Country:
Phone:
Fax:
To purchase SAILS - The price in US Dollars is $449
Shipping Prices: Canada $20
U.S. $30
Western Europe $50
Other $70
Payment Options (please select one of the following. NOTE : The information you submit here will NOT be encrypted. If you are using your credit card to pay for your order, we recommend that you print this form after you have filled it out, then fax this to us at 519-661-3805.):
Cheque or Money Order  
Visa /MC Card Number:

Expiry Date:
Month:
Year:

  Cardholder Name:
  Billing Address:
Purchase Order

 

 

 

Speech Assessment and Interactive Learning System © 2004 - 2005

 

Developed by The Software Development & Information Technology Utilization Group