                 +------------------------------------+
                 | Order Form for ROSE SWE's HackStop |#
                 +------------------------------------+#
                  ######################################
	($Id: register.txt,v 2.7 2003/09/07 17:58:04 ralproth Exp $)

    Name: _______________________________________________________________

    Company (optional): _________________________________________________

    Address: ____________________________________________________________

    City,State,Zip: _____________________________________________________

    Country: ____________________________________________________________

    Where did you get HackStop from?: ___________________________________

    What version of HackStop do you use?: _______________________________

    Date: __________________    Signature: ______________________________

----------( Version )---------

( )  Normal Registration, Euro 10,--
     Personalised Text: "Registered version of HS!"
or
( )  Personalised Registration, Euro 20,--  [please don't use (c) by...]

     Text (up to 4 lines): ______________________________________________

     ____________________________________________________________________

     Personalised versions are a little bit harder to attack than the
     normal versions. As a bonus all HackStop'ed programs carries your
     personalised text inside!  >>>>>       No text wanted at all: ( )

( )  Please add Euro 5,-- extra for outside Europe if we shall mail you
     HackStop. Delivery via email is free!

     Disk Size:  3.5"

---------( Payment )---------

( )  I have enclosed an Check for registering HackStop. Checks must
     be drawn in Euro! Please use non negotiable checks!

( )  I have transfered the money (ONLY in Euro) to your account:
     >> Non German users (Europe):
        Ralph Roth, IBAN DE37 5105 0015 0238 1111 29
        	    SWIFT-BIC:NASSDE5XX

     >> German users or Worldwide:
        Ralph Roth, Account Number 238111129, BLZ:  510 500 15
        Nassauische Sparkasse

( )  I have enclosed the money in bills at my own risk! Use a registered
     letter if you have doubts! Cash in Euro or US$ is accepted.

We can not accept credit cards! Do not send coins!

Please send to                           or FAX to
~~~~~~~~~~~~~~                           ~~~~~~~~~
     ROSE SWE                                   ROSE SWE
     Dipl.-Ing. Ralph Roth                      Dipl.-Ing. Ralph Roth
     Finkenweg 24
     D 78658 Zimmern                            FAX:    +49.731.553310
     Germany                                    CET:    08.00 - 21.00!

Thank you for registering HackStop!  Origin: 1.21b248 (27-Aug-2003)
