    ORDER FORM FOR CREDIT CARD ORDERS FROM SHAREWARE-AUSTRALIA
    ==========================================================

Use this form only if you are ordering by FAX or mail from 
Shareware-Australia. DO NOT SEND CREDIT CARD ORDERS DIRECTLY TO 
KATMAR SOFTWARE.  Send the completed form to :-

                                  **NOTE**  This address is for
  Shareware-Australia             ORDERS ONLY. Any questions on
  PO Box 1075                     the status of the shipment of
  Maroubra NSW 2035               the order, refunds, registration
  Australia                       options, product details, 
                                  technical support etc must be
  FAX  (02)9565-2362              directed to Katmar Software's
                                  South African or email address.

Registration for  :  Packed Column Calculator by Katmar Software 
                                                  __
Licence type :  Single User Licence $Aus 125-00  |__| (tick one)
                Site Licence        $Aus 400-00  |__|

Note : Prices above are in **Australian** Dollars

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     : Bankcard/Mastercard/AmEx/Visa  (circle one)

Credit Card Number   : ___________________________________________

Expiration Date      : _________________________________ ( mm/yy )

Total Amount in $Aus : __________________________ (see cost above)


Signature            : ______________________Date : ______________
