Scarsoft/BMT Micro Printable Order Form http://www.scarsoft.com ** Please see the bottom of this form for important information ** ** Please Type or Print Clearly ** Please use the Print button in your browser to print this form. Fill out the printed form, and then send or fax it with your payment to: Mail Orders To: BMT Micro PO Box 15016 Wilmington, NC 28408 U.S.A. Or Fax Orders To: (910) 792-1889 (24 Hours / 7 Days a week) Name (Please Print):_________________________________________________ Address:_____________________________________________________________ _____________________________________________________________ City:________________________________State / Province:_______________ Zip / Postal Code:___________________Country:________________________ Phone Number:________________________________________________________ Fax Number:__________________________________________________________ E-Mail Address:______________________________________________________ Alternate E-Mail:____________________________________________________ Mark your choice below - All prices are in US Dollars ** Order any 2 or more games, and take 20% off the total! ** [ ] Eeppo...............................................$9.99 [ ] Zerogear............................................$7.99 [ ] Pattern Panics!.....................................$7.99 SUBTOTAL: $__________ 20% DISCOUNT WHEN ORDERING ANY 2 OR MORE GAMES: $__________ SUBTOTAL AFTER DISCOUNT: $__________ [ ] CD-ROM shipping....................................$10.00 (all games checked will come on one CD-ROM. Shipping is included in the $10.00 fee, no matter what country US Priority Mail) SUBTOTAL INCLUDING SHIPPING: $__________ NORTH CAROLINA RESIDENTS ONLY ADD 7% SALES TAX: $__________ TOTAL: $__________ Payment Method (circle): CASH / CHECK / MONEY ORDER / DEUTSCHE BANK VISA / MC / DISCOVER / AMERICAN EXPRESS DINERS CLUB / CARTE BLANCHE / JCB / EUROCARD ** Please make check or money order payable to "BMT Micro" ** ** All checks or money orders in US Funds only ** Please add the following information for credit card orders: Card Number:____________________________________Exp. Date:_____/_____ EXACT Name on Card:__________________________________________________ Signature:___________________________________________________________ Important Ordering Information ============================== We accept Visa, Mastercard, Discover, American Express, Diners Club, Carte Blanche, Cashiers Check, Personal Check. Personal checks are subject to clearance. Euros, Sterling, and US Currency is welcome but please send by registered mail, return receipt requested. We cannot be liable for lost cash sent through the mail. If you reside in a country with an unconvertible currency please contact us for alternatives. ORDERING FROM INSIDE EUROPE ONLY ================================ Persons in Europe wishing to order shareware may also transfer funds into our account with Deutsche Bank. Once the money is deposited you may either fax a confirmation to us with proof of deposit or wait until Deutsche Bank notifies us of the transaction (usually 10-18 business days). Account information is as follows: Deutsche Bank / Frankfurt Branch Empfänger: Thomas Bradford Konto-Nummer: 0860221 Bankleitzahl: 500-700-10 When you make the transfer, be sure to put your name and the program you are registering on the transfer. It is very important that you send us a completed order form by either email or fax if you deposit money into this account for a registration. Fill the order form out as usual except in the credit card number field put "DEUTSCHE BANK". We will file the order and use it to match against the deposit information we receive from the bank. IMPORTANT! ---------- When you fax or mail us your order form, we will reply to the email address above with an acknowledgement. If you do not get an acknowledgement within 7-10 business days for mail orders, please send your order again in case it was lost. This extra bit of caution can save a lot of confusion. If you are concerned that your order is taking too long to process, feel free to check with us about the status of your order. It's important to all of us that you feel safe doing business with our company and please feel free to suggest ways we can improve our service to you. ** Thank you very much for ordering! **