Fax
To send your order via fax please print and fax the completed form to:
775-924-4436
Product and purchase information:
Merchant name: Mystic Media
Description: Blaze Media
Pro
Purchase amount: $50.00
Billing address information:
Name:_______________________________________________________________
Street (Line 1): ________________________________________________________
Street (Line 2): ________________________________________________________
City: ________________________________________________________________
State / Province: _______________________________________________________
ZIP / Post Code: _______________________________________________________
Country: _____________________________________________________________
Phone: ______________________________________________________________
E-mail: ______________________________________________________________
Product ID:
The Product ID can be located by running the trial version of Blaze Media Pro, clicking the "Help" menu, and selecting the "Register" option. The Product ID will be listed in the lower-left corner of the resulting window. If your trial period has expired, this window will display automatically when attempting to access the program. If you have not already downloaded the Blaze Media Pro trial version, please do so now and follow the above instructions for obtaining the Product ID.
Product ID: ___________________________________________________________
Credit Card Information:
Only credit card orders can be received via fax. Please supply the below information:
Card Type: ____________________________________________________________
Card Number: _________________________________________________________
Expiration Date: ________________________________________________________
Signature: _____________________________________________________________
Thank You For Your Order!