EquineMax Order Form      

Rancho Media, LLC
P.O. Box JG
College Station, TX 77841
Fax: (877) 637-8463 / Phone: (877) 637-8463  

If submitting order by mail, please allow 7-10 business days for your order to be received and processed.

 
Pleasure (Unl. Horses) $125   Performance (Unl. Horses) $175   Small Business (Unl. Horses) $295
Pleasure (10 Horse limit) $75   Performance (10 horse limit) $95   Small Business (25 horse limit) $195

Name:_______________________________________________________________________

Farm/Ranch:___________________________________________________________________

Mailing Address:_______________________________________________________________

City/State/Zip:_________________________________________________________________

Phone Number:________________________________________________________________

E-mail:_______________________________________________________________________

Credit Card Information (if paying via credit card):

Card Type   Visa    Mastercard  Discover    American Express
Card Number ______________________________________   Exp ____________   CVC ____________
The CVC (card verification code) is a 3-digit number located on the back of the credit card)

Additional computer licenses? ($35 each) ______

Online backup service?($40 year)______

Total enclosed _________