Name:
Function:	Teacher IT specialist Deputy Head Teacher Head Teacher Administrator Bursor Parent Student Other
School Name:
Street address:
Town, Post Code:
School Telephone No:
Your Email Address:
License Bands:	£10 total for 1 PC £15 total for 2 PCs £20 total for 3 PCs £25 total for 4 PCs £30 total for 5 PCs £35 total for 6 PCs £40 total for 7 PCs £45 total for 8 PCs £50 total for 9 PCs £55 total for 10 PCs £100 total for 20 PCs £140 total for 30 PCs £170 total for 40 PCs £200 total for 50 PCs £226 total for 60 PCs £250 total for 70 PCs £270 total for 80 PCs £286 total for 90 PCs £300 total for 100 PCs £350 total for 200 PCs £400 total for 300 PCs £450 total for 400 PCs £1 each for 499+ PCs	Quantity:
Single/Multiple:	Single Network(single £costx5)	Total Value:
Media type:	electronic download CD (UK add £10)
I agree to Pay by:	Official Order, details below Official Order, details to follow Money order sent next day Cheque sent by next day Using PayPal other, specified in notes below
Send / deliver:	immediately/as soon as possible on receipt of order details wait for order & include invoice when payment made other, specified in notes below
Invoice required:	confirmation by Email is OK send proforma invoice to me send proforma invoice to School invoice to me including Order ref. invoice to me on receipt of Order invoice to School quoting Order ref. invoice to School on receipt Order other, details in notes field

As applicable: School Order detail/Delivery address/Serial Number(s)/Notes: