Pass Order Form

BEHAVIORSYSTEMSDESIGN

ORDER FORM

PASS is a full featured computerized behavior monitoring/reporting system for use in behavior management programs. PASS will prepare daily check sheets (PASS sheet) to be conveyed by the student, a daily coordinator report which ranks and reports on overall progress, check sheets (PASS Mail) that can be sent through the building mail to obtain student behavior data, and individual weekly reports (PASS Report) which thoroughly and graphically detail progress against a baseline. PASS utilizes action buttons called shortcuts which simplify program use.

PASS works best on Apple Macintosh G3 computers (32+ megs memory), and laser printers. ClarisWorks 4.0 v4 or v5 software must be installed on your computer before you will be able to use the PASS program. ClarisWorks is available from Apple Computer Corporation.

PASS registered users are granted limited rights to authorize use of PASS program files and documentation for use only at the school/district/cooperative named below. Reports and forms may be copied/used only as necessary in the implementation of behavior change programs for students/clients of the site named below. Any other use is a copyright infringement.

The individual PASS School package price is $200 which includes registration for the first year. PASS is delivered on a floppy disk which includes all necessary files (except ClarisWorks 4.0 v4 or v5) & manual. The annual tech support and user reregistration fee for each active school is currently $50. The district/cooperative package price is $500 (plus $50 per school if over 10.) Inservice is only available during the 1999-2000 school year . A one day inservice costs $300 per day plus expenses.

Fill out this form completely, print it out, and mail it along with your completed Sch. /Dist./ Coop purchase order to Behavior Systems Design, 620 West Rice Street, Stillwater, MN 55082.

Purchaser

All fields are required in this section. Start in first box, fill out, then tab to go to the second box, etc.

First order or reregistration:
First Name:
Last Name:
Sch. /Dist./ Coop:
Business Address:
City / State / Zip:
Phone:
Fax:
Email:
Your PO #:
Purchase Order Date: 2002

Bill to

(These fields required if different than Purchaser)
Attention:
Sch. /Dist./ Coop:
Business Address:
City / State / Zip:
Phone:
Fax:

Ship To

(These fields required if different than Purchaser)
Sch. /Dist./ Coop:
Attention:
Shipping Address:
City / State / Zip:

Updated: