======================================================================== InterCom v3.x registration form InterCom is Copyright (c) 1995-96 by Jonathan Tew. All Rights Reserved. ======================================================================== Note: Each registration of InterCom comes with at least two licenses for InterCom. Note: InterCom is distributed via BMT Micro and other companies. These companies are in no other way affiliated with Revolutionary Software or InterCom. Note: There is a new company taking registrations for asian and pacific countries. ---------- World Wide ---------- Mail Orders To: BMT Micro PO Box 15016 Wilmington, NC 28408 U.S.A. Voice Orders: 8:00am - 7:00pm EST (-5 GMT) (800) 414-4268 (Orders only) (910) 791-7052 (Orders / Order Inquires) Fax Orders: (800) 346-1OS2 (1672) 24 hours, 7 days a week Online Orders via BBS: (910) 350-8061 10 lines, all 14.4K (910) 799-0923 28.8k v.FC via Compuserve: Thomas Bradford, 74031,307 via Internet: orders@bmt.wilmington.net We accept Visa, Mastercard, Discover, American Express, Diner's Club, money order, cashiers checks, and personal checks. We also accept DM and British currency via registered mail. Personal checks are subject to clearance. We accept purchase orders from educational institutions, governmental agencies and other verifiable businesses. Terms are "Due Upon Receipt" with a $250 minimum. Name: ____________________________________________________________ Company: ____________________________________________________________ Address: ____________________________________________________________ ____________________________________________________________ City: _______________________ State/Province: __________________ Country: ____________________________ Postal Code: __________________ Phone: ____________________________________________________________ Fax: ____________________________________________________________ Email: ____________________________________________________________ Product Price Quantity Total -------------------------------------------------------------------- ( Funds below specified in US dollars ) _InterCom v3.x__________________ $_29.99__ x ________ = $____.___ ________________________________ $________ x ________ = $____.___ ________________________________ $________ x ________ = $____.___ ________________________________ $________ x ________ = $____.___ ________________________________ $________ x ________ = $____.___ Subtotal: $____.___ North Carolina residents, please add 6% sales tax: +$____.___ Shipping (check one): ___ Email (subject to credit card verification Free ___ Fax (subject to credit card verification Free ___ 1st Class ................................. Free ___ Airborne (Next day most places, USA Only).. +$___7.00_ ___ Federal Express (USA Only)................. +$__13.00_ ___ Federal Express (Canada/Mexico)............ +$__25.00_ ___ Federal Express (Europe/Japan)............. +$__30.00_ ___ Express (Outside USA) ..................... +$__20.00_ Total: $____.___ For credit card payment only: Circle one: VISA / Master / Discover / AMEX / Diner's Club Credit card number: _____________________________________________ Expiration date: ___/___ Authorization signature: _____________________________________________ --- Additional ordering information for our German customers--- If you reside in Germany and wish to register InterComm locally you can deposit the registration fee into our account in Germany. The registration fee using this method is 46 DM diskless / 50 DM with diskette. Empfanger: Thomas Bradford Konto-Nummer: 0860221 Bankleitzahl: 500-700-10 After depositing the money, you can fax confirmation of the deposit to 910-350-2937 along with the registration form -or- you can wait until we are notified by Deutsche Bank that your deposit has been made, usually within 7-10 days. ------------------- Asian/Pacific ------------------- Mail Orders To: Taiyotech Singapore Pte Ltd No. 1, Rocher Canal Road #06-53/31 Sim Lim Square Singapore 188504 Voice Orders: 11:00am - 9:00pm (65) 338-4123 (Orders / Order Inquires) Fax Orders: (65) 336-2376 24 hours, 7 days a week via Internet: taiyo@mailhost.net We accept Visa, Mastercard, American Express, Diner's Club, money order, cashiers checks, and personal checks. Singapore currency is most welcome. Personal checks are subject to clearance. Name: ____________________________________________________________ Company: ____________________________________________________________ Address: ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ City: _______________________ State/Province: __________________ Country: ______________________ Postal Code: __________________ Phone: ____________________________________________________________ Fax: ____________________________________________________________ Email: ____________________________________________________________ Product Price Quantity Total --------------------------------------------------------------- Intercom__________ US$29.95___ x ________ = US$____.___ Subtotal: US$____.___ Shipping (check one): ___ Email (subject to credit card verification Free ___ Fax (Singapore Free ___ Federal Express (Outside Singapore)........ +US$__10.00_ Total: US$____.___ For credit card payment only: Circle one: VISA / Master / AMEX / Diner's Club Credit card number: _____________________________________________ Expiration date: ___/___ Authorization signature: _____________________________________________ Note: For payment in Singapore dollars, please contact taiyotech for exact price.