Registration Form for Easy GIF Animator
Customer Information
Last name: __________________________________
First name: __________________________________
Company: ___________________________________
Street and #: ________________________________
City, State, postal code: _______________________
Country: _____________________________
Phone: _______________________________
Fax: _________________________________
E-Mail: _______________________________
*** Please do not forget to include your e-mail address.
We will use e-mail to communicate with you.
How would you like to receive the registration key?
e-mail fax postal mailHow would you like to pay the registration fee:
credit card wire transfer check cashCredit Card Information (if applicable)
Credit Card:
Visa
Eurocard/Mastercard
American Express
Diners Club
Card Holder: _________________________
Card No.: ___________________________
Expiration Date: ______________
Date / Signature: ______________________