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!