
METAMILL REGISTRATION FORM
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Please read the readme.txt file for information how to order.
Program ids and other important information can be found there.


Program-ID : ________________________

Quantity : ______

Last Name: _______________________________________

First Name: _______________________________________

Company: _______________________________________

VAT-ID-No. (if applicable) ________________________

Address:  _______________________________________

Postal Code and City: _______________________________________

Country: _______________________________________

Phone: _______________________________________

Fax: _______________________________________

E-Mail: _______________________________________

Note: A valid e-mail address is needed in order to receive 
      the registration key.


How would you like to pay the registration fee:

	credit card - wire transfer - check - cash

Credit Card Information (if applicable)

Credit Cards: 	Visa - Eurocard/Mastercard - American Express - 
		Diners Club

Card Holder: ________________________________

Card No.: ___________________________________ 

Expiration Date: ________

Date / Signature: ___________________________


