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1. How many Scanners do you want to RENT? ⓘ

Standard Scanners

Quantity	Cost Per	\|
1-3	$70/each	\|
4-7	$58/each	\|	Number of Requested Scanners:
8+	$54/each	\|

Premium Scanners

Quantity	Cost Per	\|
1-3	$87/each	\|
4-7	$72/each	\|	Number of Requested Scanners:
8+	$67/each	\|

Email address for individual using standard scanner(s) ⓘ

Email address for individual using premium scanner(s) ⓘ

2. How many Access Codes do you want? ⓘ

Number of Seasonal Access Codes ($59/season) ⓘ :

Email address for individual using Seasonal code on mobile app(s)

Number of "One Day Use" Codes ($25/day) ⓘ :

**IMPORTANT--this "One Day Use" access code can ONLY be used between 12:00 AM and 11:59 PM on the date it is activated. All leads MUST be uploaded the same day. Any leads NOT uploaded by 11:59 PM may be lost. This “One Day Use” access code can only be used on one device/phone and is non-transferable. It must be partnered with a seasonal rental of some kind and cannot be ordered on its own.

Email address for individual using "One Day Use" code on mobile app(s)

3. How many Leads (student scans) do you want? ⓘ

Number of Requested Leads:

- or -

Unlimited ($1200)

4. Email address to receive scanned student data

Check here if the scanned student data should be sent to the individual using the device.

If the scanned student data should be sent to one individual only, provide their email address below.

Email address:

5. Do you use bulk mail to send information to students?

With our address verification service, a student's self-reported address will be converted to USPS bulk mail compliant format. This information will be added to leads and will not replace the self-reported address. Address verification service is valid for the entire season of your rental, but does not transfer season to season. This service is provided at a flat rate of $100 per season.

Yes, I want address verification service

Email:
Phone:

(Please provide a copy of your logo)

6. Shipping Information (No PO Boxes)

First Name:		City:
Last Name:		State:
Email:		Zip:
Company:		Country:
Address 1:		Phone:
Address 2:

7. Billing Information

Same as Shipping
First Name:		City:
Last Name:		State:
Email:		Zip:
Company:		Country:
Address 1:		Phone:
Address 2:

8. Payment and Delivery Information

Shipping Method (All shipping methods include FedEx 3 Day return shipping)
FedEx 3 Day	FedEx 2 Day	FedEx Standard Overnight	FedEx Priority Overnight
INTERNATIONAL ECONOMY	INTERNATIONAL PRIORITY	Your FedEx Shipping Cost is: $		Calculating...	You have to enter a shipping address before choosing the service type

Tax Exemption
Are you tax exempt? (Please provide a PDF copy of your Tax Exempt Certificate) If you are tax exempt and have not attached a copy of your tax exempt certificate to this order, please fax a copy to 209-720-1885 within 24 hrs or you will be charged the appropriate state tax.

Payment Method (Download W-9 form) (Show Billing Address)
TRC Corporation, 29 Emmons Drive, Suite F-10, Princeton, NJ 08540
Visa Mastercard American Express Check (Payable in US Funds to "TRC Corporation")

Card Number:
Cardholder Name:
Expiration Date:	/
CVV Number:

9. Terms and Conditions

Check box to accept our Terms and Conditions

You will be able to confirm your order on the next page before a final submittal.

Order Summary

	Qty	Price	Total
Standard Scanners	0
Premium Scanners	0
Seasonal Access Codes	0
One Day Use Codes	0
Leads	0	$.12
Address Verification		$100

Tax			$0
Shipping			$0
Total			25

Please make check out to Technology Resource Corp. and send to 29 Emmons Drive, Suite F-10, Princeton, NJ 08540.
P.O. Number:
	Please fax a hard copy of your purchase order to 209-720-1885.
	Important note: orders placed via check payment method will not be released for shipping until payment is received.

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