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Order Form
 
Client Status
Please indicate below whether you are ordering as a new Titanium client, ordering as a current Titanium client, or making a Request For Quote. You must make a selection before proceeding to the other boxes below.



Contact Information
Please provide us with the following information for the person we should contact about your purchase of Titanium Schedule.
Contact name: 
Title:
University:
Dept/Center:
Address:
Email:  
Phone:   Fax: 

Order
Please check the products, optional features, and services you want to order. If you want to order multiple copies of Titanium Schedule for other departments or centers, please place each order separately.
Note: Our base product is Titanium Schedule for 5 users, and additional licenses are offered in 5-user blocks. For example, if you are ordering Titanium for a center with a staff of 14 people, you should order Titanium Schedule for up to 5 users and 2 Additional 5-user blocks.
ItemOrderQuantityPrice 
Titanium Schedule
for up to 5 users		$1,300 first year
$1,075 per year after 1st year		 
Additional
5-user blocks		 $200 per block first year
$40 per block per year after 1st year		 
Pre-pay annual
licensing fee1		 Optional (see below)
DSM-IV™ Codes2$175Optional (see below)
Data Conversion3$1,500 and upOptional (see below)
Client Import4$400Optional (see below)
Web Component5$100 per yearOptional (see below)
Remote Training6$350Optional (see below)
  

Additional Information
If you have any current computer data you want imported into Titanium, please specify the current data format (e.g. Protégé, Rutgers UCCD, Access database, etc.)
When do you plan to install Titanium Schedule? (e.g. ASAP, this summer, next fall, etc.)
How would you like to pay (e.g. Purchase Order, Check, MasterCard/Visa)? Please do not include sensitive information like credit card numbers.
Comments: