Individual GIDEON Order Form

This form is for individual orders requesting an invoice or via a corporate purchase order or check. See: Credit card orders, Institutional orders.

Please fill out this form and:
1. Press Submit,
or 2. Print and fax to: +1 (413) 487-9264,
or 3. Print and mail to: 8721 Santa Monica Blvd, Suite 234, Los Angeles CA 90069, USA

Ship to:
E-mail address:
Full Name
Position
Institution
Address Line 1
Address Line 2
City
State / Province
Postal Code
Country
Phone
How did you hear about GIDEON?
Comment:
 

I would like to subscribe to GIDEON with the following plan:

  $995
GIDEON Web only – individual – annual subscription
 
$1,350
GIDEON Web + CD – individual – annual subscription
 

Payment method:

Check in US$ to “GIDEON Informatics” (Print form and send with check to 8721 Santa Monica Blvd, Suite 234, Los Angeles CA 90069, USA)

Purchase order number:

Invoice me / Bill me / Bank transfer (Submit form – invoice will be e-mailed to you, including bank transfer details)

I agree to the terms of the license agreement