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Unlimited Use Order Form NS, Canada
Yes! I want to continue using Donarius® beyond the 30 day trial period.
Please send me an activation code for the base version plus these modules:
[] Pledge Tracking The base version is $67.97
[] "Gifts in Kind" and "Gifts with Advantage" and each module is $18.00
[] Pre-authorized Deposits / Online Donations Subtract 25% from your order
[] Customized Tax Receipts if you will have 100 active
[] Letters, Emails & Text Messages donors per year or less
[] Relationships and Families
[] Photo Directory
My Serial # is: A3 - _____ - _____ (click on Serial Number on the main window)
Name: _________________________________
Church: _________________________________
Address: _________________________________
_________________________________
Here is my phone #, in case you need to contact me: _________________
Send the activation code to this
email address: ___________________________
I would like to pay:
[] with a cheque or money order for the
amount in the chart below, payable to:
Nuverb Systems Inc.
27 Lawnview Dr.
Toronto, ON M2N 5J9
[] Send me a CD - I will add $10.00 + HST to my cheque.
[] by VISA, MasterCard, AMEX or Discover
Charge my card for the amount circled in the chart below
Card #: _______ _______ _______ _______ Expiry Date: ___ / ______
Name on Card: ______________________ Signature: _____________________
Total cost with HST depending on how many modules you want:
Just Base Version 1 Module 2 Modules 3 Modules 4 Modules 5 Modules
$78.17 $98.87 $119.57 $140.27 $160.97 $181.67
Total cost with 25% off:
$58.63 $74.15 $89.68 $105.20 $120.73 $136.25
Thank You GST# 882072374
A receipt will be sent to you by email. All items are F.O.B. Toronto, Canada