           Order Form
                                             EasyFractal 3 (Shareware)

This is to confirm that I would like to become a registered user of EasyFractal 3. The shareware fee within Europe amounts to 20 EUR and 20 USD in the USA and other countries. I will pay this fee as indicated below.
The Upgrade EasyFractal 2 to EasyFractal 3 costs 10 EUR or 10 USD.
As a registered user of this software, I will be notified by e-mail about upcoming new versions of this program. My contribution also supports the further development of EasyFractal.

Please print out this form (for best results set the print size to 80% using the menu option "Page Setup" from the File menu), fill it out, and send it via postal mail to:

   Berkhan-Software
   Alt-Isenhagen 19
   D-29386 Hankensbuettel
   Germany

or fax the form to:  ++49  5832 / 6160

Of course, you may also register via e-mail by sending the required information to: 
                    
                info@berkhan.com       Subject: EasyFractal

or on our wedsite at http://www.berkhan.com

After your payment has been received, you will be send your registration number immediately, either via fax, e-mail, or postal mail. 


First and Last Name: ______________________________________________________________________

Street:              ______________________________________________________________________

City, State, ZIP:    ______________________________________________________________________

Country:             ______________________________________________________________________

Email:               ______________________________________________________________________

Telephone / Fax:     ______________________________________________________________________


I am already registered for EasyFractal 2:       Yes        No

My registration number for EasyFractal 2 is:  _____________________________________________



Payment Options:   

Credit Card:  Name on Card:       ___________________________________________________________

                Card No.:           ___________________________________________________________

                Expiration Date:    ___________________________________________________________

                Security ID:        ___________________________________________________________



Check:         Non-Negotiable Check / Euro Check is enclosed.

Cash:          Value of  _______ EUR / USD  is enclosed.



_______________________________________________________________________________________________
City, Date, Signature




