FAX Payment to ShoftShop for ByronSoftware ID50168

Please print this form, fill it out and fax it:

Following are our fax numbers - all are toll free unless marked with a *.
If your country is not listed please fax to the UK number +44 1297 553366

ShoftShop accept most cards including Discover, JCB, Eurocard, Diner's Club, Delta, Switch,
Visa, Amex, Mastercard but there is a 4% surcharge on Diner's Club
Card orders by fax to SoftShop incur + 2 UK pounds manual processing fee.

Software Licence(s) required from ByronSoftware ID 50168:-

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Email address .. .. .. .. .. ..

Name to register (ie School) .. .. .. ... ..

Serial Numbers (if known) . . . . . . . . . . . . . . . . . . . . . .

Card Holder's Name (Capitals please) ______________________________

Credit Card #: _ _ _ _-_ _ _ _-_ _ _ _-_ _ _ _

Exp. date: _ _/_ _ _ _(mo/year)

Issue Number SWITCH only _ _ _

Card holder's signature: __________________________________

Be sure all your information is correct. Orders are normally processed within 1 business
day after we receive the order. Immediately after we process the order, an email confirmation
will be sent and ByronSoftware can then provide the codes.

Thank you for your custom.

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