Order Products

Broderick Data Systems Trial Order Form

Important! - Please provide complete information. Incomplete or missing information could result in a shipment delay of your trial order.

Check the products you wish to order for the 30-Day Free Trial:

Where did you see our products advertised?

Referred by:
Other:

System

Serial Number

AS/400 Models

Shipping address:

*Attn:

*Company Name:

*Address:

Address2:

*City:

*State:

*Zip Code:

*Country:

*Telephone:

*Fax:

*E-mail:

* Reenter E-mail:

U.S. Mail Options:

Priority Mail. Sent via US Priority mail at no charge to you. Delivery within 2-3 days. Continental U.S. shipments only.
Airmail. Sent via Airmail at no charge to you. Delivery time varies. International and Canadian shipments only.

Federal Express Options:

$35 Domestic= Next Day morning delivery
$55 International=Next Day morning delivery
$10 Saturday Delivery Additional
If you have a Federal Express Account number, we can bill the shipping charges to your account. Please provide your account number below in the 'comments' box.

Bill to address same as Ship to address? Yes No

If no, please provide Billing address below.

*Attn:

*Company Name:

*Address:

Address2:

*City:

*State:

*Zip Code:

*Country:

*Telephone:

*Fax:

*E-mail:

* Reenter E-mail:

Additional comments or notations:

SpoolOrganizer/400™	Remote SpoolPrint/400™
E-mail Utilities™	FileXfer3X/400™
Spool PDF Overlay/400™	Remote Backup Organizer for IBM i™