

Mail this form and a check/International postal money order to:

    MochaSoft
    Faksegade 13,1tv
    2100 Copenhagen East
    Denmark

Products:

Mocha Telnet:
  1  to   4  Users: Licenses of $80  each = ______
  5  to  10  Users: Licenses of $150 each = ______
  11 to 200  Users: Licenses of $500 each = ______

  Unlimited Company licens:    $2000 each = ______

Danish Residents add 25% tax              + ______

Total:                                      ______



Wants to receive a receipt by surface mail (yes/no) : _____
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 - Prices are based on the number of browsers downloading
   the Java applets simultaneous, from a single host.

 - If You wish to download the products from more than one
   host, fill out a copy of this order form for each host.
 
 - If the Check is not drawn on a Danish bank add 70 US for
   extra cost. 

 - Using Danish Checks,  1US = 6.00 dkr

Licens name: ___________________________________ (will be displayed
                                                  in the help window)

Name:________________________________________  Date:_______________

Company:___________________________________________________________

Contact Person: ___________________________________________________

Address:___________________________________________________________

City, State, Zip:__________________________________________________

Country:___________________________________________________________

Phone Number:______________________________________________________

E-Mail Address:____________________________________________________


If You want to speed up the order handling, send also this file via
email to frydendal@mochasoft.dk
