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Wrap
Text File
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2003-06-03
|
69KB
|
489 lines
+---------------------------------+
| e-merge GmbH | This form expires on January 1, 2005.
| Friedrich-Ebert Str. 157 |
| |
| D-48153 Muenster | Date:___________
| GERMANY |
| |
| Phn +49-251-43000 |
| Fax +49-251-43052 | Signature:____________________________
+---------------------------------+
Name: Phone:
________________________________________ _____________________________
(Company/Institution): (Email):
________________________________________ _____________________________
Address:
________________________________________________________________________
Zip/Country: (FAX):
________________________________________ _____________________________
I wish to get a licence for use of ActiveAce/WinAce
[ ] on one computer (1 CPU) ...................... $29 _______
[ ] on 2 to 4 CPUs ... number of CPUs: ___ x $24 _______
[ ] on 5 to 9 CPUs number of CPUs: ___ x $19 _______
[ ] on 11 to 49 CPUs number of CPUs: ___ x $17 _______
[ ] on 60 to 99 CPUs number of CPUs: ___ x $14 _______
For larger amounts please contact a registration site directly.
Visit us at http://www.winace.com fot a list of resellers.
Shipping of files:
[ ] by regular mail................................ $5 _______
[ ] by email....................................... $0
(Address must be given in the fields above!) ___________
TOTAL: US$
=======
-------------------------------------------------------------------------
You have to specify an authenticity verification string:
(please read the file ACE.DOC for information about this)
_______________________________________________________________________
(min: 10 chars; max: 50 chars; pay attention to upper and lower case)
-------------------------------------------------------------------------
Method of payment:
[ ] Bank transfer to the following account:
e-merge GmbH, Sparkasse Muenster, BLZ 400 501 50
account nr. 17 006 834, purpose "ACE registration"
[ ] Cheque
[ ] Cash (add money to this order, maximum is $63)
[ ] Credit card [ ] Eurocard [ ] VISA
_______________________________ _______________________________
Cardholder Signature
_______________________________ _______________________________
Credit card number Expiry date