CreaToon 1.2 FAX ORDER FORM

Please fill out and sign our order form (mandatory fields are labeled in red).
Then print it out and fax it to ANDROME N.V. at +32 11 301331

After checking your credit card, the amount of 299 EURO / 299 US$ will be charged on your card and the registration code will be either E-mailed or faxed to you.

Important: we do not sell or rent our list of customers to anyone.

Name:
Email:
Company :
VAT number:
Address1:
Address2:
City:
ZipCode:
State/Province:
Country:
Telephone:
Card:	VISAMastercard
Card number:
Name on card:
Expiration date:
Signature: