Ordering Respondus "offline" using a credit card, check or purchase order

Prepaid Activation Codes for “single-user” licenses of Respondus can be ordered by credit card, check or purchase order. 

Select one purchase option below and complete the form details:

[  ]  Purchase Order
Payment terms are net 30. Purchase orders can be sent to:
Respondus, Inc. 
P.O. Box 3247
Redmond, WA  98073
Email: sales@respondus.com

[  ]  Check
Check payments must be in US dollars and can be sent to: 
Respondus, Inc. 
P.O. Box 3247
Redmond, WA  98073 

[  ]  Credit card
Provide the email address for credit card holder: 					
      (A secure payment link will be sent to the email listed above) 

Respondus 4 single-user license: Quantity: ______  	@ $149 each  	$____________

Sales tax* (if applicable)	$____________
					
Total Payment			$____________

*Sales tax: if you are located in one of these states, please either include sales tax in your order, or provide a copy of your sales tax exemption certificate along with your order.
	Arizona
Illinois
Massachusetts
New Jersey
New Mexico
	New York
North Carolina
Texas
Washington
Wisconsin	
					
Send To Information (license details will be sent to the email you provide below)

Name: 		_________________________________________________________________________
Institution: 	_________________________________________________________________________
Address: 	_________________________________________________________________________
City, State/Prov	_________________________________________________________________________
Zip/Postal: 	__________________________Country: 	_____________________________________
Phone: 		__________________________ Email:	_____________________________________

Respondus cares about your privacy and the security of your personal data. For more information, refer to the Respondus Privacy Policy. California residents may also refer to the Notice at Collection.