Payment by credit card for shareware
                                  "EpsonShare"
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            Postal courier                 |              Fax
                                           |
          Send this form to:               |         Send this form to:
               S.E.S                       |
         1, rue de stockholm               |     From France: 02 31 14 90 18
            75008. Paris                   |    From Foreign: +33 2 3114 9018 
               FRANCE                      |
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 Pricing  
 
 The server price varies by the number of clients you want to serve.
 
                        Number      French 
                      of Clients    Francs       Euros     $USD
                                                   
                           1         150          25       24
                           3         250          41       39
                           5         350          57       56
                          10         550          90       89
                          20         750         123      119
                          50         950         155      153
                
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 Your order
       
 Currency
   If you reside in France, thank you to pay in French Francs. Euros only for
   countries of the European community. Dollars US for all other countries.
        

        Clients           Product            Price and Currency  

          ...           EpsonShare           ..................
 
                           Total             ..................
 
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            Your name: ...............................................
          
  Your e-mail address: ...............................................
          
         Your country: ...............................................
           
      Your fax number: ...............................................

   Your printer model: ...............................................   
           
    Credit card type  (Visa,American Express or Eurocard/Mastercard):
              
              ...............................................
              
                      
    Your credit card number: ...................................
    
                Expiry date: ...................................
              
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 Authorization
    
             I authorize S.E.S to charge my credit card for
                       (Amount and Currency)
                        
                 ......................................
                        
                        
                             signature:
                        


 
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