Website Quotes can be added to your website if you are a subscriber to Compulife's Quote software.

Please print and mail this completed application with your check to:

Compulife Software, Inc.                           Print This Application/License
19 Pickett Court
Mitchell, Ontario N0K 1N0

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_________________		Result Template Name  (ie. TEMPLATE.HTM)
		$104	One Year subscription   (Pro-rated to match your subscription)
	____	+$60	Health Analyzer
	____	+$50	Domain Hosting
	____	+$50	Needs Analysis Caculators (one time charge)

Amount (Please add 6% GST or 14% for HST) (Ontario residents also add 8% PST):	$__________
Your Name	______________________________________________
Phone Number:	______________________________________________
E-mail Address:	______________________________________________