Registration for a Net 30 Account

Use this form to apply for an Open Account with MindFusion. Once your account
has been created, you will be able to purchase products using your Purchase Order Number.

Your Name:



Company Name (if applicable):




Corporate ID or SSN:




Billing Address

Country:



City:     State (if applicable):



Street Address:



Postal Code (Zip):



Telephone:



Fax (if applicable):



E-mail:



By submitting this form, applicant understands and agrees that all invoices are due and payable 30 days after our invoice date. All software products shall remain MindFusion's property. Ownership does not pass to the buyer until all licenses are paid in full.