Order form for Crime Fighter
If you want to send your credit card information by postal mail, please print out this page and send the completed form to one of the following addresses:
European customers: | US customers: |
element 5 AG / Shareit!
Vogelsanger Strasse 78
D-50823 Koeln
Germany
|
ShareIt! Inc.
P.O. Box 844
Greensburg PA 15601-0844
USA
|
|
Order form for Crime Fighter
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Program No.: 103282 Price: US$ 10,- / DM 20,-
Last name: _______________________________________
First name: _______________________________________
Company: _______________________________________
Street and #: _______________________________________
City, State,
postal code: _______________________________________
Country: _______________________________________
Phone: _______________________________________
Fax: _______________________________________
E-Mail: _______________________________________
How would you like to receive the registration key?
[ ] e-mail [ ] fax [ ] postal mail
Credit card information:
Credit card: [ ] Visa [ ] Eurocard/Mastercard
[ ] American Express [ ] Diners Club
Card holder: ________________________________
Card No.: ___________________________________
Date of Expiration : ________________________
Date / Signature ____________________________