Zeus for Windows Order Form =========================== Send all orders to: Jussi Jumppanen Xidicone Pty Ltd PO BOX 697 Lanecove NSW 2066 Australia All prices quoted are in Australian dollars only. ************************************************************************** Postage Details: Please supply me: with quantity _____ @ $AUS 50.00 each = ___________ (which includes postage and handling) Total Payment: $AUS ___________ Name: ____________________________________ Date: _____________ Company: __________________________________________________________ Address: __________________________________________________________ __________________________________________________________ __________________________________________________________ City, State: _____________________________ Zip: ___________________ Country: _____________________________ Media Size: 5.25" Disk ____ or 3.5" Disk ____ or Either size ____ ************************************************************************** Credit Card Details (if applicable): Card holders Name: ___________________________________________ Card Type: Mastercard ___ Visa ___ Bankcard ___ Card Number: |__|__|__|__| |__|__|__|__| |__|__|__|__| |__|__|__|__| Card Valid: ____ / ____ to ____ / ____ Phone Number: (____)__________________ Signature: ____________________________________________ ************************************************************************** Important Note: All remittance will be in Australian Dollars ($AUS) only, based on the exchange rate at the time of purchase. Consult the current exchange rate for the approximate cost in other currencies. **************************************************************************