For your convenience, you can complete this form online and then print it.
 
Mail to:
Jolly Giant Software Inc.
1120 Finch Ave. W., Suite # 701-778
Toronto, ON Canada M3J 3H7

Or: fax it to us at: (613) 544-2459, Voice: 613-541-0740, Email: sales@jollygiant.com
 

Ship to Address:
 
Name
Company Name
Address
City, State/Province
Zip/Postal Code, Country
Phone Number 
E-mail Address

Order information:
 
Product Description
Unit Price**
Quantity
Total
(US $)
QWS3270 Plus (1 year of maintenance included)  
$115.00
QWS3270 Secure (1 year of maintenance included)  
$125.00
QWS5250 (1 year of maintenance included)  
$115.00
2 Day Air Delivery (US/Can. only)
$50.00
Shipping and Handling (7-10 days)  
$15.00
Email Delivery (within 24 hours)  
N/C
Total 

Credit Card information: Please Note: VISA, MasterCard or American Express only 

Card Number
Expiry Date
Name on Card
** Credit card orders are processed in Canadian dollars adjusted to coincide with currency rate fluctuations.