Name: _______________________________________________
Address: _______________________________________________
Address 2: _______________________________________________
Zip code: __________ Town: ______________________________
Phone: _______________________________________________
E-Mail: _______________________________________________
Homepage: _______________________________________________
I would like the full version shipped
( ) by e-mail
Please send me the full version of Akiko. The registration
( ) as cash
----------------------------- snip -----------------------
( ) by mail (please attach 2 USD/2 EUR for postage)
fee of 15 USD/15 EUR is enclosed with this mail
( ) as a check (checks can be only accepted from Europe!)
( ) as a postal money order
Date: _____________ Signature: __________________________
Andreas Falkenhahn
An der Trift 2
36132 Eiterfeld-Arzell
GERMANY