Registration For Chameleon Clock

Product ID # 5223
Option 1 : Order by Fax - Fill in the form below, print it out, and FAX it to 770-497-9234.
Option 2 : Order by Mail - Fill in the form below, print it out, and Mail it along with a check in US Dollars to :
RegSoft.com, Inc.
PMB 201
10820 Abbotts Bridge Road
Duluth, GA 30097
Option 3 : Order by Voice - Call 1-877-REGSOFT (1-877-734-7638) (international orders please call 1-770-497-9126). Please include the below Product ID as well as any required fields below.
Option 4 : Order Online - Go to secure online order page.
For purchase orders and volume discount information please visit our site.

Product ID5223
Program NameChameleon Clock
Registration $24.95
Quantity
Total payment

Billing Information:
Email Address:
user@domain.com
Name:
as it appears on credit card
Company Name:
(optional)
Address:
Exactly as it appears on your statement
Address (cont):
City:
State/Province:
Country:
Postal Code:
Phone Number:

Please be sure your email address is correct! This is how you will receive your registration confirmation.
HOTMAIL email addresses, and other email forwarding addresses are NOT accepted
 
CC Type: Visa
MasterCard
American Express
Novus (Discover)
Card Number:
Card Expiration Date:
  
Signature: __________________________________

By signing, you agree to pay the above indicated fees, billed
by RegSoft.COM to your credit card account, for this order.

I would be interested in purchasing a RegSoft.COM Shareware CD-ROM at a later date. The CD would include the most recent shareware from the RegSoft.COM shareware site.