                  Order/Registration Form


To:

	Dr. Gottfried Siehs
	Tiergartenstrasse 99
	A-6020 Innsbruck
	Austria / Europe



I / We want to register HD95COPY 2.2

Name: _________________________________________________________

Company: ______________________________________________________

Address: ______________________________________________________

Town/City: ____________________________________________________

Country: ______________________________________________________

Post Code: ______________

Phone: __________________  FAX: ______________________

E-mail: ______________________________________________




User name string for registration (max. 80 characters)
  
_______________________________________________________________


Number of copies to register: _______

Total payment   : ___________________

via
( ) cheque
( ) sending cash (should only be sent by registered post)
( ) bank transfer to
	sterreichische Postsparkasse, BLZ 60000
	Kto-Nr 7786.901
	(Dr. Gottfried Siehs)


Thank you for registering HD95COPY!
