Your Address: |
First and last name: |
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Address 1 |
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Address 2 |
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City |
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ZIP Code |
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Country |
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Phone / Fax |
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email |
If you do not place your email address here we will send you the key code
to your postal address or Fax it. |
For the Academic-Version please submit the following
information: |
You are: student
teacher scientific assistant
lecturer other: |
Complete address of your educational institution: |
College / Institute |
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Field of Study |
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Address 1 |
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Address 2 |
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City |
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ZIP code |
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Country |
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Phone, Fax: |
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Tell us your desired method of payment:
Customs, duty, tax, and applicable fees may be assessed on your
purchase. You will have to pay these charges separately when you receive your package. For European citizens:
use the comment field at the bottom of this form (or email ) to ask for the
prizes in your currency. If you live in a country belonging to the European Union you have to add 16% VAT. |
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Prepayment Check to
Berkhan-Software, Alt-Isenhagen 19, D-29386 Hankensbuettel / Germany
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Wire Transfer/Direct Bank Transfer to:
Postbank Hannover/Germany, Account 6789 50-307, Bank Code 250 100
30 (only within Europe)
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Payment by Credit Card:
VISA Master Card Eurocard
Name as it appears on the card:
Credit card number:
Expiration date:
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Do you have any comments, questions or wishes? |
Have you written programs in Omikron Basic before?
Yes
No
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You will receive a confirmation via e-mail within 24 hours.
Please contact us in any case of discrepancy. Phone: +49 58 32 - 97 98 95, Fax: +49 58 32 - 61 60 or e-mail us:
info@berkhan.de (Subject:
"order")
Please feel free so send us a message if you have any problems
with this order form or any additional questions.
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http://www.berkhan.com
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© 1997-1999 Berkhan-Software
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