Print out this form and send it filled out to the following address: Kai Seidel Traunsteiner Str. 19 83355 Grabenstaett GERMANY ----- 8< --------------------------------------------------------------------- Text-Wandler V3.9 Registration Form ----------------------------------- Name: ___________________________ Date: _______________________ Mailing Address: _________________________________________________________ City: ____________________________ State: ____ Zip:___________ Country: ____________________________ Phone: +____-(__)___________-____________ EMail: ________________________________________________________ ________________________________________________________ ________________________________________________________ Computerconfiguration (type, equipment, accessories etc.): ________________________________________________________ ________________________________________________________ ________________________________________________________ Where did you receive this program: _____________________________________ German DM US$ I would like to get: X a registered version of Text-Wandler.........15.00 10.00 o I'm sending a disk with this registration form for copying the registered version to it........................................--.-- --.-- o I'm not sending a disk. I'll pay for it.......1.00 1.00 o I live outside of Germany. To cover the additional costs of air mail I add............5.00 5.00 I am sending... o a EuroCheque.................................--.-- --.-- o a wire bank transfer.........................--.-- --.-- o cash (German DM or US $ only)................--.-- --.-- p & p 3.00 3.00 ==================== This gives a TOTAL AMOUNT of ____________________ Bank-Address : Raiffeisenbank Chieming-Grabenstaett eG, Account 230227, Bank-ID 701 691 11 I have read the copyright and warranty stuff and agree with them. _____________________ ____________________________________________ (Date) (Signature)