AxMan Fax Order Form
(Fax to 425 - 392 - 0223)
Please provide the following information:
Product AxMan
Name (First and last)
Company*
Street address
City
State / Province
Zip / Postal Code
Country
Phone number
Email address**
Quantity
Name on card
Type of credit card***
Card Number
Expiration Date (Month and Year)
* - You may leave the company field blank if you are registering this as a personal copy.
** - This is the email address that you want your registration information sent to. Please make sure that you enter this correctly or we will be unable to deliver the registration information to you.
*** - Visa, Mastercard, Amercian Express, and Discover(Novus) accepted