Complete the form below to register your IOMSKGEN software. IOMSKGEN REGISTRATION FORM ========================== PROGRAM: # COPIES AMOUNT IOMSKGEN C Source Generator (30.00 Euro) Operating System: MS-DOS _______ Euro________ Operating System: LINUX _______ Euro________ Add 3.00 Euro Postage/Handling if required _______ Euro________ TOTAL . . . . . . . . . . . . . . . . . . . . Euro________ PAYMENT INFORMATION: ==================== MasterCard ___ Visa ___ Bankcard ___ Cheque/Money Order ___ Card Number :__________|___________|____________|____________ Expiry Date :_____/_____ Card Issued To :________________________________________________ Signature :________________________________________________ YOUR MAILING ADDRESS: ===================== Name :________________________________________________ Address :________________________________________________ City/State :________________________________________________ Country/PostCode :________________________________________________ Voice/FAX/Modem :________________________________________________ Email Address :________________________________________________ __________________________________________________________________ FAX : Registration Forms to +49 228 68 96 347 (Germany) PHONE: +49 228 67 72 87 (Germany) MAIL : Dipl.-Phys. Robert Warnke Saarbrueckener Strasse 79 D-53117 Bonn GERMANY __________________________________________________________________ Email: Internet FTP: WWW: http://www.robert-warnke.de __________________________________________________________________