B.A.T.L Advanced Technology Order Form

Please fill out and print the following order form:

B.A.T.L Advanced Technology, Ltd.
20 Hanasi
Hadera, 38131 Israel
P.O Box 3121
B.A.T.L Order Form - Check payment Sales: (972) 462-47637
Fax: (972) 462-48228
sales@batl.com

Please complete the following information and mail this form with payment.

Name: Address:

Title:

Company: City:

Phone: State/Province:

Fax: Postal Code:

E-Mail: Country:

Number of
GTW420 Pro Licenses Cost per License $ Subtotal $

Number of GTW420 Licenses Cost per License $ Subtotal $

Total $

B.A.T.L Advanced Technology, Ltd. 20 Hanasi Hadera, 38131 Israel P.O Box 3121	B.A.T.L Order Form - Check payment	Sales: (972) 462-47637 Fax: (972) 462-48228 sales@batl.com

Please complete the following information and mail this form with payment.

Name:				Address:
Title:
Company:				City:
Phone:				State/Province:
Fax:				Postal Code:
E-Mail:				Country:

Number of GTW420 Pro Licenses	Cost per License	$	Subtotal	$
Number of GTW420 Licenses	Cost per License	$	Subtotal	$
			Total	$