EchoView Pro (v5) Order
=======================


NAME:

BILLING ADDRESS

Street/Number:
Town:
County/State:
Zip/Postcode:
Country:


MAILING ADDRESS

Street/Number:
Town:
County/State:
Zip/Postcode:
Country:


Home Phone:

Work Phone:

Fax Number:

E-mail Address:


I would like my personal registration 
number(s) to be sent to me by...
	 
      E-MAIL  /  FAX   /   REGULAR MAIL



I WOULD LIKE TO ORDER...


[  ]EchoView Pro single licences 

@ 14.99 (US Dollars)  = Total:[	]



[  ] Echoview Pro educational licences 

@ 119.99 (US Dollars) = Total:[	 ]


           TOTAL DOLLAR AMOUNT:[	  ]



Credit Card Information...

Type: 

   VISA  / MASTERCARD  /  AMEX 


Name (as on card): [			]


Account Number: [ 			]


Expiry Date:		/


I authorize AXXIS(TM) Internet to bill my credit card and 
agree to pay the total amount according to the card issuer
agreement. 


Date [	           ] 

(If ordering by fax or post, please sign) 


==================================================================

If you are paying by check (cheque), please delete the credit card 
details above, then complete...

I enclose a check for [	        ] 

------------------------------------------------------------------

* BEFORE ORDERING PLEASE READ THE COPYRIGHT NOTICE AND 
  DISCLAIMER SUPPLIED WITH THE SOFTWARE


* PLEASE ALLOW A COUPLE OF DAYS FOR YOUR ORDER TO 
  BE VERIFIED (longer if by post)


* REMEMBER - SECURE ONLINE ORDERING VIA THE INTERNET 
  IS A ~~FASTER WAY TO GET YOUR ORDER

  
e-mail enquiries to Ian Tragen:   ian@europemail.com