ALLOS SpA B.go Padova 170 35013 - Cittadella - PD ITALY Phone: ++39-049-9414411 Fax: ++39-049-9414430 http://www.dmtools.com mailto:salesdm@dmtools.com ===================== Software Order Form ===================== Fax or EMail this form to ALLOS or use the easy and secure automated on-line ordering system on our web page. Today's Date: ____/____/_____ Name: _______________________________________________________________________ Company: ____________________________________________________________________ Address:_____________________________________________________________________ City:_______________ State:____ Country:_______ Zip or Postal Code: ________ Phone: ( ) _____________________________________ Fax: ( ) _____________________________________ E-Mail Address: __________________________________ (REQUIRED) ****** IMPORTANT ******** Last 5 Digits of Director S/N:_____________ (Win) Last 5 Digits of Director S/N:_____________ (Mac) Last 5 Digits of Authoware S/N:_____________ (Win) **************************** Product Price PC Vers. MAC Vers. Both Vers. DMFade 50 Euro 50 Euro 79 Euro DMTransition Pack 1 99 Euro 99 Euro 149 Euro DMTransition Pack 2 99 Euro 99 Euro 149 Euro Bundle DMPack1+DMPack2 149 Euro 149 Euro 219 Euro DMTransition Xtreme 99 Euro 99 Euro 149 Euro DM Waves effect 69 Euro 69 Euro 99 Euro DM Stars Field effect 69 Euro 69 Euro 99 Euro Bundle Waves + Stars fx 99 Euro 99 Euro 149 Euro ------------------------------------------------------------------------ Mastercard __ Visa __ AmEx __ (Sorry, no C.O.D. or credit terms) Cardholder Name (Please Print):_____________________________________ Card Number: ___________________________________________________ Expiration Date: _________________ Cardholder Signature: _____________________________________________