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Text File
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1995-07-03
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2KB
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107 lines
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Credit Card Registrations (USA Only!)
This form must me mailed for all credit card registrations. When registering
on 21st Century Support BBS, a signed form must be received for order
confirmation.
Name:
Company:
Address:
City: State: Zip:
Telephone:
Fax:
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Pricing: USA
Private license w/o NLM 35 $
Via mail: 39 $ ______
Private license with NLM 55 $
Via mail: 59 $ ______
Additional modemservers 20 $
____ X 20.00 ______
The private license is not for
use in companies! The mechanisms
for supporting multiple users, like
queueing and assigning available
modem-servers are only built into
the commercial version.
Commercial versions (incl. printed manual):
2 servers / 1-25 Workstations 230 $
4 servers / 1-25 Workstations 390 $
10 servers / Unlimited WS 590 $ ______
- 1 -
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Card Information
Select one: VISA MASTERCARD
Card Number:
Expiration Date:
Name of Card Holder:
(as it appears on the card)
Bank or Card Service:
Total Amount:
Date: Signature:
A charge to 21st Century Communications will appear on your billing.
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Please supply a way for us to send you the registration key:
- Fax
- Fido
- Internet e-mail
- Mail (please note the surcharge above!)