Traverse PC: Education Verification Form

www.traverse-pc.com

Land Surveying Software

Celebrating 20 Years - Since 1987

Traverse PC Education Verification Form

Mail to: Traverse PC, P.O. Box 105, Florence, OR 97439

Fax to:(541) 997-3546

This form must be filled out completely and signed by you and your instructor to qualify for the Traverse PC Desktop Student Edition. Failure to completely fill in the form may result in a delay or denial of your order.

Student Name	Instructor Name
Address	Address
Address	Address
City	City
State/Province	State/Province
Postal Code	Postal Code
Country	Country
Telephone	Telephone
e-mail	e-mail
Major	Institution Name
Minor	Course Name

I understand that this software is not transferable or upgradeable. I certify that I am a student in the course described above and that I am ordering this software to use in the course of my studies. I give my permission for Traverse PC to contact my instructor and me to verify these statements.

__________________________________________
Student Signature

__________________________________________
Date

I certify that I am the instructor of the course described above and that this person is a student in my class. I give my permission for Traverse PC to contact me to verify these statements.

__________________________________________
Instructor Signature

__________________________________________
Date