LSS+ ORDER FORM FROM SECURITY.ORG

ORDER LSS+ FROM SECURITY.ORG

This is a combined order and registration form. If you have purchased LSS+ from a distributor, you need to fill out the REGISTRATION form for LSS+. If you wish to place an order for copies of more than one security level, you must fill out a separate order form for each version.

	WHICH VERSION OF LSS+ DO YOU WISH TO ORDER?
	If Medeco Book selected, please choose option.
	DO YOU ALREADY HAVE THE CD?
	NUMBER OF COPIES
	VENDOR
	PURCHASE DATE
	INVOICE NUMBER
	PRODUCT SERIAL NUMBER
If you already have a preview copy of LSS+, you can enter the challenge code to receive your unlock code.
	CHALLENGE CODE
Note: if you are ordering the LOCKSMITH or GOVERNMENT version, you must provide information regarding your employment.

PERSONAL DATA
	NAME
	E-MAIL ADDRESS
	JOB TITLE OR RESPONSIBILITY
	ADDRESS
	CITY
	STATE
	ZIPCODE OR POSTAL CODE
	PROVINCE
	COUNTRY
	WORK PHONE
	CELL OR RESIDENCE PHONE
	EMPLOYER NAME
	EMPLOYER ADDRESS
	CITY
	STATE
	ZIPCODE
	PROVINCE
	COUNTRY
	EMPLOYER TELEPHONE
	SUPERVISOR NAME
	NCIC OR INTERPOL ORI IF GOVERNMENT AGENCY
	I AM A MEMBER OF THIS PROFESSIONAL ASSOCIATION
	PROFESSIONAL ASSOCIATION NUMBER

PRIOR SECURITY.ORG REGISTRATION AND BOOK PURCHASE?
	I HAVE PREVIOUSLY REGISTERED FOR A SECURITY CLEARANCE ON SECURITY.ORG
	SECURITY.ORG USER NAME
	I HAVE PURCHASED A COPY OF LOCKS, SAFES, AND SECURITY AND REGISTERED IT.
	The 12-digit code that is on the registration certificate

SHIPPING INSTRUCTIONS
	PREFERRED METHOD OF SHIPPING
	DELIVERY
Charges for other than first class mail in the United States shall be charged at actual rate and added to total.
	SHIP-TO ADDRESS
	CITY
	STATE
	ZIPCODE OR POST CODE
	PROVINCE
	COUNTRY

CREDIT CARD DATA
	CREDIT CARD TYPE
	NAME ON CARD
	CARD NUMBER
	EXPIRY DATE MM/YY
	CARD SECURITY PIN (Not ATM Pin)
	CARD BILLING ADDRESS
	CITY
	STATE
	ZIPCODE
	PROVINCE
	COUNTRY
I hereby authorize charges to be made to the above credit card for purchase of LSS+, together with any applicable shipping and handling costs. I understand that the cost of LSS+ PUBLIC is $275.00; LSS+ LOCKSMITH is $350.00, and LSS+ GOVERNMENT is $600.00. I certify that I am the cardholder, or authorized to use such credit card, and in the event that the charge is declined by the card issuer, I shall be personally liable for all charges for this transaction.
	DATE
	ENTER NAME AS ELECTRONIC SIGNATURE