Order Form

Use this form to order SCRIP 2000 or iScrip from Sunshine Software Solutions

Organization           Name:   _____________________________________________________________

                               Address:  ____________________________________________________________

                             City:  __________________________________ State: ____  Zip:  _______________

                             Phone: (____)_________________  Organization FAX:  (____)__________________

                             E-mail Address:  _____________________________________________________

Ship to                  Name:  ___________________________________________________________________

                             Address:__________________________________________________________________

                             City:  _____________________________________ State: ____  Zip:   ________________

Contact's               Name:  _________________________________________________________________

                             Phone:  (____)________________  E-mail Address:  _______________________________

How did you find out about iScrip?  ______________________________________________

UNITED STATES:

[  ] Please send iScrip for $199.99 $0.00 s/h = $199.99 (US Dollars).  Price includes free initial training and setup.

[  ] Please send SCRIP 2000 for $239.99 + $10.00 s/h = $249.99 (US Dollars).  Price includes software and User Guide.

[  ] Please send SCRIP 2000 replacement disc for $80.00 + $5.00 s/h = $85.00 (US Dollars).

[  ] Please send an additional SCRIP 2000 User Guide for $15.00 + $5.00 s/h = $20.00 (US Dollars). 

[  ] Please send an additional SCRIP 2000 Authorization Code for $49.99 + $0.00 s/h = $49.99 (US Dollars). 

[  ] Please send an additional SCRIP 2000 License for $100.00 + $.00 s/h = $100.00 (US Dollars). 

CANADA: To speed delivery, please use paypal or an International Money Order drawn from a US bank.

[  ] Please send iScrip for $199.99 $0.00 s/h = $199.99 (US Dollars).  Price includes free initial training and setup.

[  ] Please send SCRIP 2000 for $239.99 + $30.00 s/h = $269.99 (US Dollars). Price includes software and User Guide. 

[   ] Please send SCRIP 2000 replacement disc for $80.00 + $15.00 s/h = $95.00 (US Dollars).

[  ] Please send an additional SCRIP 2000 User Guide for $15.00 + $15.00 s/h = $30.00 (US Dollars). 

[  ] Please send an additional SCRIP 2000 Authorization Code for $49.99 + $0.00 s/h = $49.99 (US Dollars). 

[  ] Please send an additional SCRIP 2000 License for $100.00 + $.00 s/h = $100.00 (US Dollars). 

Method of payment is by check or paypal. We do not accept credit cards. Please mail this completed form and a check for the full amount to:

Sunshine Software Solutions

4435 Nantuckett Drive

Toledo, OH 43623-3113

Questions:  E-mail:  nwoscrip@gmail.com