CIFELLI, cPEG™ C 3.0 rev 1.5 Quotation Form

To obtain a quotation for the cPEG™ C 3.0 rev 1.5 PCI DVD/MPEG2 decoder card, including all shipping and handling charges, complete the following form, and press SEND when you are done.

Note:
1. Unless otherwise indicated, all fields must be completed.
2. Base prices subject to change without notice.
3. Shipping & handling charges will be computed according to the shipping address you provide below.

      I am a/an: 
                 [ we reserve the right to re-classify you at our discretion ]
                 [ volume discounts may apply ]

       Quantity:  cPEG™ C 3.0 rev 1.5 PCI DVD/MPEG2 decoder card(s)

     First Name: 
      Last Name: 

                 Your contact info ->
   Organization: 
        Address: 
                 
           City: 
 Province/State: 
Postal/Zip Code: 
        Country: 
          Phone: 
            Fax: *[optional]
         E-mail: 

                 Shipping location (if different from above) ->
        Address: 
                 
           City: 
 Province/State: 
Postal/Zip Code: 
        Country: 

        Comments or special instructions: