  +---------------------------------+
  |  e-merge GmbH                   |   
  |  Friedrich-Ebert Str. 157       |
  |                                 |
  |  D-48153 Muenster               |                       Date:___________
  |  GERMANY                        |
  |                                 |
  |  Phn 49-251-43000               |
  |  Fax 49-251-43052               |   Signature:__________________________
  +---------------------------------+
    Name:                                      Phone:
    ________________________________________   _____________________________
    (Company/Institution):                     (Email/FIDO):
    ________________________________________   _____________________________
    Address:
    ________________________________________________________________________
    Zip/Country:                               (FAX):
    ________________________________________   _____________________________

    I wish to get a license for WinACE Archiver
    (for larger amounts please contact us directly)

     [ ] on one computer (1 CPU) ...................... $29   _______
     [ ] on    2 to    9 CPUs ... number of CPUs: ___ x $25   _______
     [ ] on   10 to   24 CPUs     number of CPUs: ___ x $22   _______
     [ ] on   25 to   49 CPUs     number of CPUs: ___ x $19   _______
     [ ] on   50 to   99 CPUs     number of CPUs: ___ x $16   _______

    Shipping of files:     [ ] by regular mail.......... $7   _______
                           [ ] by email................. $0
        (addresses must be given in the fields above!)      ___________

......    TOTAL: US$
                                                              =======
   --------------------------------------------------------------------------
    You have to specify an Authenticity Verification string:
    (the registered ACE adds this string to your archives - as your sign)

     _______________________________________________________________________
     (min: 10 chars; max: 50 chars; pay attention to upper and lower case)
   ---------------------------------------------------------------------------
    Method of payment:
     [ ] Wire transfer to Postbank Dortmund/Germany
           Bank access code: 440 100 46, account nr. 418 480 467,
           SWIFT Code: PBNKDEFF (optional), purpose "WinACE Archiver"
     [ ] Cheque
     [ ] Cash (add money to this order)
     [ ] Credit card          [ ] Master-/Eurocard   [ ] VISA

           _______________________________   _______________________________
           Cardholder                        Signature

           _______________________________   _______________________________
           Credit card number                Expiration date
   ---------------------------------------------------------------------------
    Please tell us about the type of data your are using ACE on.
    (this helps me to improve the program)

     [ ] Text       [ ] Sound       [ ] Executables (com,exe,dll,..)
     [ ] Graphics   [ ] Database    [ ] Other: _____________________________
