Wordtracker Order Form

To order Wordtracker via mail or fax, please print and complete
this order form.  Mail it along with your money order or a check
payable to: "Rivergold Associates Ltd" for the subscription amount
and send it to:

Unit 11-12,
Apollo Studios,
Charlton Kings Road,
London NW5 2SB
United Kingdom

You can also fax it with your credit card information  to:

020 7424 8844 (UK) / +44 20 7424 8844 (Outside UK)

We'll send your login information via email within 24 hours of
receiving your order, and you can get started immediately.

Please write your details in BLOCK CAPITALS. Be sure that the
email address listed below is correct.

Company: ____________________________________________________

Contact Name: _______________________________________________

Phone Number: _________________ Fax Number: _________________

Email Address: ______________________________________________


Street Address 1: ___________________________________________

Street Address 2: ___________________________________________

City: _____________________ State/Province: _________________

ZIP/Postal Code: ______________ Country: ____________________

Database information:

Username: ___________________ Password: _____________________

Please include payment for your subscription amount.

Available reports and cost:

Top 10,000 keywords report - USD $69.00 / GBP £35.00 
Top 20,000 keywords report - USD $137.00 / GBP £70.00 
Top 100,000 keywords report - USD $677.00 / GBP £345.00 

Credit Card Number: _____________________________Type:_______

Name on Card: ______________________ Exp. Date: _____________

Security Code (3 digits on back of card): ___________________

Signature: __________________________________________________

Credit Card Billing Address: (if different from above)

_____________________________________________________________

_____________________________________________________________