PredictProtein Payment

Name:
E-Mail address:
Company:
Address:
Phone:
Fax:
I agree to the terms and conditions found in the license agreement. Please issue me the password for using PredictProtein.

Invoice for payment:

I do not need an invoice for payment.
I should like to receive dated invoice by e-mail.
I should like the invoice faxed to me.
I should like the invoice mailed to the above address.

Number of Maximal Requests:

 up to  50 predictions during one year = US$ 2000
 up to 250 predictions during one year = US$ 4000

Payment Method:

I shall send you a check for the respective amount.
I shall fax/mail you a Purchase Order for the amount.

Comments:

By clicking on the Submit button you agree to the conditions found on the License Agreement.

Important Information: