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Boardmaker® Software Family
CD Replace Lost – Canada
If your version 6 CD was lost and requires replacement, please follow the instructions below.
1. Proof of purchase (serial number, copy of your invoice, copy
of your software, actual software, etc.) for the lost product to
be replaced. Provide one of the following:
2. Mail this form, and check, money order, P.O. or Credit Card
payment to:
Attention: Replacement CD
Mayer-Johnson, LLC
2100 Wharton Street
Suite 400
Pittsburgh, PA 15203
-- Software Registration/Serial/Product ID Number:
____________
-- Original P.O. #: _____________
-- Original Order # MJ: _____________
3. You can also fax it to 1-866-585-6260 or email it to
MJQ@tobiidynavox.com
-- Proof of purchase if ordered through a reseller
Customer Name:
Email:
Role (Spec. Ed. Teacher, SLP, etc):School/Organization:
Phone Number:
Fax Number:
Bill to Address:
Ship to Address:
Name:
Name:
Organization:
Organization:
Address:
Address:
City/Province/Postal Code:
City/Province/Postal Code:
*If using a credit card make sure you include the name and address
of the credit card holder.
Attn:
Quantity
Price
Software
Mac
Win
CA$75
Boardmaker
� 120LTV6
� 125LTV6
CA$75
Boardmaker Plus!
� 1MJ175LTV6
� 1MJ100LTV6
CA$75
Boardmaker Studio
CA$100
Boardmaker with Speaking Dynamically Pro
Shipping - See grid below
Method of Payment
Subtotal
Tax
Grand Total
Shipping Costs
Orders CA$0-99
CA$5
Orders CA$100-$499
CA$10
Orders CA$500+
CA$25
� 1MJ410LT
� 145LTV6
Credit Card:
Check #:
CC Number:
Make payable to Mayer-Johnson, LLC
Name on CC:
Purchase Order: Please attach or fax
Expiration
Date:
� 145WLTV6
� Visa
Signature:
REV 10/23/14
2100 Wharton Street • Suite 400 • Pittsburgh, PA 15203 • 800.588.4548 • mayer -johnson.com
Copyright © 2014 Mayer-Johnson. All rights reserved.
� Master Card
Security
Code: