IES Educational Order Form

Your Name	^*
University or College	^*
Department	^*
Mailing Address	^*
City	^*
State/Province	^*
Zip/Postal Code	^*
Country	^*
Phone
E-mail	^*
Web Site	(Please provide the best web page to verify your status at the school.)

Choose One^*:
	Student VisualAnalysis License, US$20 Download (Single-user, 1 school year license, expires in August 2008)
	2-yr Student VisualAnalysis License, US$35 Download (Single-user, 2 school year license, expires in August 2009)
	Department/School VisualAnalysis License, Free Download (On-campus use for qualifying universities or colleges in North America only, orders accepted from faculty members only, please!)

Payment Method

Card or PO Number:
Expiration Date: Card ID:
Note: If credit-card billing address is different, please enter it below!

(Note: Orders are processed manually, M-F 8:30AM - 4:30PM MST)