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- | 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:____________________________
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- Name: Phone:
- ________________________________________ _____________________________
- (Company/Institution): (Email):
- ________________________________________ _____________________________
- Address:
- ________________________________________________________________________
- Zip/Country: (FAX):
- ________________________________________ _____________________________
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- 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 _______
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- For larger amounts please contact a registration site directly.
- Visit us at http://www.winace.com fot a list of resellers.
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- Shipping of files:
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- [ ] by regular mail................................ $5 _______
- [ ] by email....................................... $0
- (Address must be given in the fields above!) ___________
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- TOTAL: US$
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- You have to specify an authenticity verification string:
- (please read the file ACE.DOC for information about this)
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- _______________________________________________________________________
- (min: 10 chars; max: 50 chars; pay attention to upper and lower case)
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- Method of payment:
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- [ ] 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
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- _______________________________ _______________________________
- Cardholder Signature
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- _______________________________ _______________________________
- Credit card number Expiry date
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