PicoWeb Order Form

Name:
Company:
Address:
City:	State:	Make checks payable to: Lightner Engineering 8551 La Jolla Shores Dr. La Jolla, CA 92037-3044
ZIP/Postcode:	Country:
Phone:	Fax:
E-Mail:	PO#:

Qty.	SKU#	Description of Item	Shipping Weight (each)	Price (each)	Shipping Weight (total)	Subtotal Price
	PW1-DEV	PicoWeb Full Development Kit (incl. PW1-SVR)	1.0 lb.	$149.00
	PW1-SVR	PicoWeb Server (w/ 110V power supply and case)	0.5 lb.	$99.00
	PW1-ASM	PicoWeb PCB (server, no power supply, no case)	0.3 lb.	$79.00
	PW1-PC	PicoWeb Programming Cable	0.5 lb.	$29.00
	PW1-FDK	PicoWeb Firmware Development Kit (CD-ROM)	0.2 lb.	$49.00
	PW1-SVX	Bare PicoWeb Server (w/ case, no power supply)	0.3 lb.	$85.00



TOTAL SHIPPING WEIGHT FOR ALL ITEMS:						lbs.
USA Orders: Indicate US Priority Mail - and pay correct amount Foreign Orders: Indicate Express Mail - and pay correct amount					ORDERING INSTRUCTIONS
*CHARGE MY CREDIT CARD: VISA MasterCard Amex Discover Expiration Date (required): / Signature: X_____________________________ Date:_______ *Note: Name & address listed on form must match card's owner				Total Amount for Items Ordered
				Calif. Deliveries Only - Add 7.75% Sales Tax
				Shipping & Handling (Refer to Charts)
				Total Amount Enclosed		$

Check, Money Order or Credit Card information MUST accompany order. DO NOT SEND CASH!

Order by fax at 1-858-551-0777 or send this order form to:
Lightner Engineering
8551 La Jolla Shores Dr.
La Jolla, CA 92037-3044

Telephone: +1-858-551-4011 FAX: +1-858-551-0777 E-mail: lightner@lightner.net

NOTICE: NO LONGER ACCEPTING NEW ORDERS!

PicoWeb FAX/Mail Order Form