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        Hutmil 3 Order Form
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Please fill out the form below.
An asterisk (*) denotes required fields.
You can pay by cheque (made out to Peter Jukel)
or cash, but it is not my responsibility 
if the cash doesn't arrive.

Privacy
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The information you supply will not be
made public, and will not be released or
sold to any other establishment.  We will
not send you junk mail.

The Hutmil newsletter solely reports
Hutmil updates and major Hutmil news/
website updates.

Procedure
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Please send the form to the following
postal address.  You will receive a 
registration key via e-mail, which will
disable the time limit.  You will be
entitled to upgrades for each license
purchased for the next version of Hutmil.

    Hutmil
    P O Box 2302
    Noorsekloof
    Jeffreys Bay
    6331
    SOUTH AFRICA


PERSONAL INFORMATION
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Name*: ________________________________

Company: _____________________________

E-mail Address*: ______________________

Postal Address*: ______________________
     
                ______________________
    
                ______________________

                ______________________

Country: _____________________________

WebSite (Personal):

______________________________________


WebSite (Company):

______________________________________

Would you like to be subscribed to the Hutmil
mailing list (Y/N): __________


PHONE & FAX
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International Dialing Code: __________

Area Code: ___________________________

Phone Number: ________________________

Fax Number: __________________________


ORDER INFORMATION
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Number of Orders at $50,00 each*: _____