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2009 OfficeMate & ExamWRITER Virtual Users' Group Video Access Order Form

* Indicates a required field.

Practice Contact Information

Salutation*
First Name*

Last Name*
E-mail*
Practice Name*
Address*
Line 1
Line 2
City
State ZIP -
Telephone Number*
( ) -
Fax Number
( ) -

Payment Information

Video Access Fee
$129
Method of Payment*
Check Credit Card, Debit Card, Bank Transfer, PayPal Payment

Check Payments

If you are paying by check, make the check payable to OfficeMate Software Solutions and write your office phone number in the memo field. Send your payment to:

OfficeMate Virtual Users' Group Meeting
15375 Barranca Pkwy.
Bldg. L
Irvine, CA 92618

Credit Card, Debit Card, Bank Transfer, & PayPal Payments

If you are paying by credit card, debit card, bank transfer, or PayPal, you will be directed to a secure PayPal Web site to complete your payment.

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For additional Virtual Users' Group Meeting information, e-mail us here or call us at 800.269.3666, option 8, ext. 2962 .