Maryland REALTORÒ Forms
Software
Maryland REALTORSÒ
PROFORMS™ Forms on Disk Software Order Form
Company Name __________________________________________ Local MLS
Broker Code __________________
Print or type name as it will
be printed on your contracts Required
Address
______________________________________________________________________________________
Use office
location address, not your post office box.
This address will appear on contracts.
City, State, Zip
________________________________________________________________________________
Telephone # _______________
Alternate Phone # ________________________ FAX # ___________________
2nd FAX # _______________
Office Computer Administrator ____________________ (contact person)
Ship To Address
_____________________________________________________________________________
Enter if different from
above Street/PO Box City State Zip
Single User ONLY - ID Desired for Software ________________ Password Desired for Software ____________
Agent Name ________________________________ EMAIL Address _________________________________
Agent Home Phone # ___________________________________ Agent Home FAX # _____________________
|
TYPE OF LICENSE |
PRICE |
QTY |
12 month Renewal |
|
TOTAL |
||
|
1
user |
$110 |
|
$65 |
|
|
||
|
3 user |
$215 |
|
$110 |
|
|
||
|
5 user |
$250 |
|
$125 |
|
|
||
|
10 user |
$350 |
|
$165 |
|
|
||
|
Unlimited
Users |
$495 |
|
$345 |
|
|
||
|
Sub TOTAL |
|
||||||
|
Shipping and
Handling Software (All Orders) |
|
|
9.95 |
||||
TOTAL
|
$ |
||||||
If this order is for 3 or more
users, please include an Email address for each user.
Payment Method: Make check payable to
Omega Software Solutions, Inc.
Check _____________
Number _____________ Amount $
____________
Credit Card Information:
Name: ___________________________
Type: circle one MC
VISA
Card Number: _______
_______ _______ _______
Expiration Date: ____________
Billing Address for Charge
____________________________________________
Order Placed By _________________ Signature for charge _________________
INSTRUCTIONS
FOR ORDERING WITH THIS FORM:
1. Complete applicable sections.
2. FAX Credit Card orders to OMEGA SOFTWARE
SOLUTIONS, INC. (813) 891-6898 or
3. Mail order form with check to: Omega Software Solutions, PROFORMS Division
2042
Norfolk Dr. Holiday, FL 34691
IF YOU HAVE QUESTIONS, PLEASE CALL
OMEGA Software Solutions, Inc. (813) 891-6767 FAX (813) 891-6898