-----------------------
     Simone Tellini                      Order form for
     Piazza Resistenza 2
     42016 Guastalla RE                      STFax
     ITALY
   -----------------------


        Dear Simone,

        I'd like to register to STFax, please send me my keyfile.

        I'd like to receive the keyfile by

            ( ) Snail Mail
            ( ) E-Mail       (PGP public key needed)

        I include the registration fee of

             Country     |  Fee         |  Method of payment
             ---------------------------------------------------------
        ( )  Italy       |  LIT 45.000  |  Contanti, vaglia, assegno
             ---------------------------------------------------------
        ( )  Europe      |  LIT 50.000  |  Cash, postal money order,
                         |              |  EuroCheques
             ---------------------------------------------------------
        ( )  Rest of the |  US $ 35     |  Cash, postal money order
             world       |              |  NO CHEQUES!
             ---------------------------------------------------------


        Name  __________________    Surname  _________________________

        Address  _____________________________________________________

                 _____________________________________________________

                 _____________________________________________________

                 _____________________________________________________

        Country  _____________      Phone Number  +___________________

        FAX  ___________________    E-Mail  __________________________

        Date  __________________    Sign    __________________________



Amiga owned:               Kickstart:               Memory:   ___  Mb

( ) 500    ( ) 500+        ( ) 1.3    ( ) 3.0       HardDisk: ___ Mb
( ) 2000   ( ) 3000        ( ) 2.04   ( ) 3.1
( ) 1200   ( ) 4000        ( ) 2.1                  Modem
                                                    Model: ___________
                                                    Baud:  ___________

Comments:
    __________________________________________________________________
    __________________________________________________________________
    __________________________________________________________________