Ainsworth Order Form
Purchase Order # _________________ Tax Exemption Number _______________________

Name ________________________________________________________________________________________

Organization ___________________________________________________________________________________

Street address __________________________________________________________________________________

City _______________________________________ State _________ Zip __________________________________

email ____________________________________________________________ Phone _______________________

Ainsworth Keyboard Trainer-- Typing Instruction

Keyboard Trainer Network License - client/server or stand-alone installation
Total number of computers __________ Total $_______________

Keyboard Trainer Network License - concurrent users
Total number of concurrent users __________ Total $_______________

Single-Computer License for installation on one computer only -- $60
Total number of computers __________ Total $_______________

Ainsworth Keypad Trainer-- Ten-Key Number Keypad Instruction

Keypad Trainer Network License - client/server or stand-alone installation
Total number of computers __________ Total $_______________

Keypad Trainer Network License - concurrent users
Total number of concurrent users__________ Total $_______________

Single-Computer License for installation on one computer only -- $60
Total number of computers __________ Total $_______________

Shipping and handling USA no charge. All other orders please add $20.00

Total shipping and handling $_______________Total for this order $____________________

Credit card orders ___ Master Card ___ Visa

Name as shown on card ______________________________________

Card number ________________________________________________

Valid thru ____/____

Ainsworth & Partners, Inc. -- PO Box 8, 4504 Highway H, Ridgeway, WI 53582-0008 USA
Orders 1.888.924.9234 --- Phone 1.608.924.9234 --- Fax 1.608.924.9235