Last name: ___________________________________
First name: ____________________________________
Company: ____________________________________
Street and #: ______________________________________
City, State, postal code: ________________________________
Country: _______________________________________
Phone: _____________________________________
Fax: ________________________________________
E-Mail: ______________________________________
How would like to receive the full version?
e-mail - postal mail (add 10.00 Euro) (*)
How would you like to pay the registration fee:
credit card - wire transfer - EuroCheque - cash (*)
Credit card information (if applicable)
Credit card:
Visa - Eurocard/Mastercard - American Express - Diners Club (*)
Card holder: ________________________________
Card No.: ___________________________________
Date of Expiration : ___________________________________
Date / Signature ___________________________
(*) Strike out if not applicable
| Rest of the world | USA only |
|---|---|
|
ShareIt! element 5 AG Vogelsanger Str. 78 50823 Koeln Germany |
ShareIt! Inc. Suite 1800 Chapel Hill Professional Center GREENSBURG, PA 15601-8019 USA |
|
Tel. +49-221-31088-20 Fax. +49-221-31088-29 |
Tel. 724-853-6618 Fax. 724-850-8187 |
US customers may also order by calling 1-800-903-4152 (orders only please!).