		SelfMouse  Shareware Registration Form.

(You can sent this form by email to speed up processing your
 registration, but remember to sent it with regular mail also)


Name : _______________________________________________________

Organisation : _______________________________________________

Address : ____________________________________________________
	  ____________________________________________________
	  ____________________________________________________
	  ____________________________________________________
	  ____________________________________________________

IMPORTANT IMPORTANT IMPORTANT IMPORTANT IMPORTANT IMPORTANT IMPORTANT IMPORTANT 

Registration code (at the bottom of the About window, click on "Set Point3")

		 ___.___.___.___.___.___ 


E-mail address : _____________________________________________


Shareware contribution : (cross correct 0)

     0   Single licence (1 host) :  ...............$5

     0   Multiple licence (2 hosts or more) : 
            $5 +  #_____ hosts x 3$  =   $_____ (total)



Payment (please use only choices below):

     0   Cash

     0   Eurocheck (write out in Belgian Franks (BEF) and card
                   number on the back)

     0   INTERNATIONAL(Postal) Money Order

     0   Check drawn on non-Belgian bank : PLEASE ADD $25 to total amount.
                             (costs involved in cashing-in foreign checks)

     

Total:   $________ U.S. Dollars



Comments, bugs, suggestions, wishes :



Send to :  automouse@bigfoot.com



Payment Conditions

1. Always send a registration form along with your payment. If you have a 
purchasing department, make sure they send along the registration form with the 
payment. I can not process your payment properly without this information.
Please write clearly !!!

2. Send shareware fees, bug reports and comments to:

D. Vanoverschelde 
Asbroekstraat 34
B-3440 Zoutleeuw
Belgium (Europe)

e-mail: automouse@bigfoot.com
WWW   : www.bigfoot.com/~automouse

3. Payment

a. Europe: You can send cash (dollars or Belgian Franks (BEF)) or send me a 
Eurocheck. The Eurocheck must be made payable in Belgian Franks (BEF) and the 
Eurocheck cardnumber must be on the back. The fee is 200 BEF for the first copy 
and 100 BEF for each extra copy. 

b. Outside Europe: You can send cash (U.S. dollars) or an International Money 
Order (no extra charges). If you want to send a check drawn to a bank from your 
country, please add $25 to the shareware fee to cover costs involved when 
cashing a foreign check.

Beware: do not send local Money orders or foreign drafts (e.g. U.S. Money order 
or Canadian Money Order). An International Money Order has the words 
"international money order" written on it.


Remember to take all costs on your behalf and to also send a registration form.




