ORDER FORM FOR CREDIT CARD ORDERS FROM PSL ========================================== Use this form only if you are ordering by FAX or mail from Public (software) Library. DO NOT SEND CREDIT CARD ORDERS DIRECTLY TO KATMAR SOFTWARE. Send the completed form to :- Public (software) Library **NOTE** This address is for PO Box 35705 ORDERS ONLY. Any questions on Houston the status of the shipment of TX 77235-5705 the order, refunds, United States of America registration options, product details, technical support etc FAX 713-524-6398 must be directed to Katmar Software's South African address. Registration for: Project Risk Analysis by Katmar Software (product code #15420) __ Licence type: Single User Licence US$ 80-00 |__| (tick Site Licence US$ 250-00 |__| as PsL CD-ROM : In continental USA US$ 10-00 |__| appropriate) Outside continental USA US$14-00 |__| Registration Details Your Name : ___________________________________________ Your Company Name : ___________________________________________ Your Address : ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ Your Email Address : ___________________________________________ Your Fax Number : ___________________________________________ Credit Card Details Name as on Card : ___________________________________________ Billing Address : ___________________________________________ ___________________________________________ ___________________________________________ Credit Card type : MC / Visa / AmEx / Discover (circle one) Credit Card Number : ___________________________________________ Expiration Date : _________________________________ ( mm/yy ) Total Amount in US$ : __________________________ (see cost above) Signature : ______________________Date : ______________