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Business Information
Organization*
First Name*
Last Name*
Address 1*
Address 2
City*
State / Province
Zip / Postal*
Country*
Phone*
E-mail*


* Required fields

Package Selection
Setup Fee / Monthly	$500 / $425/mo (1 location, 15 users)
Ecommerce Package	Included
Grow Module	(optional)
Processing Module	(optional)
Manufacturing	(optional)
Total to be billed	$925
Account Type
Billing Information
Credit card
Name (as it appears on card)
Billing Address
Billing City/State
Billing Zip
Credit Card number
Expiration date	/
CVVS (on the back of card)

Choose a Password
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COMMENTS
Click on the following box if you agree to our terms and conditions: here

By clicking submit, you authorize Proteus to charge the above amount for the first month, and recurring charges.