Date            ;MM/DD/YY
First Name      ;
Last Name       ;
Callsign	;
Area Code       ;
Phone           ;
Fax             ;
Email Address   ;
Shipping Address;
City            ;
Prov/ST.        ;
Country         ;
PC/ZIP          ;
Associated Club ;
Repeater Call	;
Repeater Freq	;

ORDER CONTENTS 			      

No. of IRLP Boards	;		($105 US or CDN per)
No. of CentOS CD packs	;		($25 US or CDN per)
Donation Amount		;		
Total Payment Amount	;		(Add $18 US or $15 CDN for shipping)
Currency of Payment	;		(CDN or US)

OTHER INFO

Target Delivery Date	;MM/DD/YY	(What date you will be ready to startup)


NOTE:
The IRLP service is provided on an "as is, as available" basis. 
No warranties are expressed or implied, including, but not limited to, those with 
respect to IRLP or any information or software therein.

You release IRLP.NET all possible liability or responsibility for any direct, 
indirect, incidental or consequential damages suffered by you in connection with 
your use of or inability to use any of the IRLP.NET services.

Without limiting the foregoing, IRLP.NET disclaims to the full extent permitted by 
applicable law any responsibility for and, under no circumstances shall be liable 
for, any conduct, or content, available through the IRLP.NET services.