DOS Navigator(tm) 1.35 REGISTRATION FORM
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// This information is REQUIRED in order to process your registration //
Registration Name : _______________________________________________________
(30 characters maximum - Reg Key will be for this name)
Reg Company : _______________________________________________________
(30 characters maximum - Reg Key will be for this name)
Name: ___________________________________________________________
Company: ___________________________________________________________
Address: ___________________________________________________________
City: _________________________________________________________
State/Province: ___________________________________________________________
Zip/Country: ___________________________________________________________
Where did you get your copy of Dos Navigator II ?
(if you got it from a BBS please name it)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Where did you get the first information about Dos Navigator II ?
(Where did you hear first about DN?)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
[ ] Private customer DM 65,00
[ ] Business customer DM 138,00
[ ] Site license 5 DM 570,00
[ ] Site license 10 DM 1.020,00
[ ] Site license 50 DM 4.100,00
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Total amount DM ________
Payment
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[ ] Amount paid by cheque (takes up to 10 days to clear)
[ ] Money Order (please use mailing address shown below)
[ ] Transfer to our bank account (please use bank info shown below)
[ ] Direct billing to your account (only possible in germany!)
(called Lastschrift or Bankeinzug in german)
Account Number : ___________ Bank Code : ___ ___ __
Bank Name : _________________________________________
Name of Account Holder : _________________________________
Signature of Account Holder : ____________________________
(if you send this via e-mail, *you must* be the account holder)
[ ] Credit Card (currently we only accept VISA, ask for others)
Card Number : ____ ____ ____ ____ [X] Visa
[-] EuroCard/MasterCard
Expires : __/__ [-] American Express
[-] Diners Club
Cardholder : ___________________
Your credit card statement will show the transaction as
"EuroStar BBS Kiel".
How would you like to receive your Dos Navigator II keyfile ?
Send Key via: [ ] Mail (please add DM 8,-- for disk mailing)
[ ] FidoNet NetMail to __________________________
[ ] E-Mail to ___________________________________
[ ] Download at EuroStar BBS Kiel
Our mailing address : EuroStar BBS Kiel
c/o Jens Mueller
Roonstr. 4
24105 Kiel / Germany
Our bank Account : Account # : 830 32 32
Bank Code : 210 520 90
Bank Name : Sparkasse Eckernfoerde
SWIFT : KILA DE 22
FidoNet : 2:24/24, 2:240/2100 - /2105
E-Mail : jens.mueller@eurostar.de
You can also register your copy of Dos Navigator II online by calling
EuroStar BBS Kiel. You need to have your VISA Card ready.
+49-431-338087 USR HS DS
+49-431-336504 ZYXEL 16.8
+49-431-3390018 ISDN-ELink
+49-431-3390019 ISDN-Blaster
Thank you for supporting Dos Navigator II development!
