               Order/registration-form (credit card)
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 Please use a font with a fixed character-width, for example
 Courier, to fill and print this form.
___________________________________________________________________

 You can use this form for orders by fax-modems and payment with
 credit-card. Please consider the help-file where other ways
 for ordering/registering are described. Please have a look at the
 conditions of use in the help-file.
___________________________________________________________________

 I order                     (pieces) full versions of the program
                        ----
 Program number:        BEY_010
 Program name:          HexDecCharEditor (Disk&key)
 Author:                Peter Beyersdorf
 Version:               1.0
 Environment:           Windows95
 Describtion:           Hex- and dec-editor, offering marks and
                        other features, for binary files.
 Cost per piece:        DM 29,00 (US$ ca. 17,00)
 S&H (inside Germany):  DM 5,00 (US$ ca. 3,00)
 S&H (outside Germany): DM 5,00 (US$ ca. 3,00)

 Total DM:
                        ------------------------------------------
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 My address:

 First name:
                       -------------------------------------------
 Name:
                       -------------------------------------------
 Company:
                       -------------------------------------------
 Attn.:
                       -------------------------------------------
 Phone number:
                       -------------------------------------------
 Fax number:
                       -------------------------------------------
 eMail:
                       -------------------------------------------
 Address:
                       -------------------------------------------
 Zip Code:
                       -------------------------------------------
 City:
                       -------------------------------------------
 Country:
                       -------------------------------------------
___________________________________________________________________

 Pay per credit card:

 Your credit card   (  ) Eurocard/Mastercard
 (please check):
                    (  ) VISA

                    (  ) Diners

 Card number:
                    ----------------------------------------------
 Card holder's name:
                    ----------------------------------------------
 Expires month:                       Year:
                    -----------------       ----------------------
___________________________________________________________________

 You pay with American Express, please fill here:

 Card number:
                    ----------------------------------------------
 Batch Code:
                    ----------------------------------------------
 Card holder's name:
                    ----------------------------------------------
 Expires month:                       Year:
                    -----------------       ----------------------
___________________________________________________________________

 Mail order:

 AJS Software
 Entwicklung und Vertrieb
 Anja Jurkat
 Zum Bauverein 28
 D-45899 Gelsenkirchen
 Germany

 Phone: +49-209-9552022  (no program support!)
 Fax:   +49-209-9552023
___________________________________________________________________

 You will get the latest beta-version if you order disk&key of a
 product that is still under beta-test. After the beta-test has
 finished you will get a disk with a non-beta-version.

 07/20/1997
 Subjects to change
 No warranty can be made for availability of the products
 Latest version in the web: http://members.aol.com/beyersdorf/

