CLC Order Form: Brainfuse - JobNow, HelpNow, VetNow

您的浏览器中未启用 JavaScript，因此无法打开此文件。请启用 JavaScript，然后重新加载。

Please fill in the product and price information given on your quote email.

In order to secure a deep discount for our members, CLC places a group order with Brainfuse and pays in advance for all licenses. The invoice for your portion of the group order will be emailed to the billing contact you indicate.. Please be aware that we must receive payment within 30 days of your invoice date. We will charge a 5% late fee for invoices that are not paid within 60 days.

Please note that when purchasing a subscription, CLC membership must remain current for the duration of the subscription period. CLC reserves the right to impose additional charges equaling the value of savings received on license(s) if membership lapses.

Thank you for your understanding and prompt payment.

电子邮件地址 *

Contact Information

Provide information for the person ordering. You will have an opportunity to add a billing contact later.

Ordering Contact First Name *

Ordering Contact Last Name *

Library *

Please select from the dropdown list below.

Work Phone *

IT/Website Administrator Contact Name

IT Contact Work Phone

IT Contact Email Address

Price & Confirmation

Please check off the product(s) your are purchasing. *

JobNow

HelpNow

VetNow

必填

Price - Please refer to your email quote(s) for price. *

Confirmation *

By accepting this quote, I understand that I am authorizing the Connecticut Library Consortium to place an order on behalf of my library. I agree to pay for this product at the quoted price within 60 days of the invoice date. I understand that a 5% late fee will be charged if payment is not made within 60 days.

I do not wish to renew my subscription.

必填

Billing

Please fill out the information below so that we can send the invoice to the proper person. We will email the invoice before your subscription period start date. If you require a paper invoice, we will send one upon receiving a purchase order.

Billing Contact First Name *

Same as contact name above.

其他:

Billing Contact Last Name *

Same as contact name above.

其他:

Billing Contact Email *

Same as contact email above.

其他:

Billing Contact Phone Number *

Same as contact phone number above.

其他:

Billing Contact Address *

Please Include: Street Address, City and Zip. Example: Connecticut Library Consortium, 234 Court St, Middletown CT 06457

Purchase Order

If you will be using a P.O., please provide P.O. number if you have it.

Do you have any questions or comments?

您回复的副本将通过电子邮件发送到您提供的地址。

提交

清除表单内容

切勿通过 Google 表单提交密码。

reCAPTCHA

隐私权条款

此内容不是由 Google 所创建，Google 不对其作任何担保。举报滥用行为 - 服务条款 - 隐私权政策

表单