          

Mail this form and a check to:

    MochaSoft
    Vibevej 31
    2400 Copenhagen NV
    Denmark

Products:

Mocha W32 PPP:
  __ single user Licenses of 9.95 USD each             = ______

  __ shipping (Use our online registration and
               save the 5 USD !)                         _5 USD

Danish Residents add 25% VAT                           + ______

Total:                                                   ______



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 - From http://www.mochasoft.dk it is possible online to order with 
   a credit card and save the 5 USD shipping cost.

 - You can pay with a check in any hard currency. Just use an exchange
   rate from a newspaper. Please do not issue a check in USD, if
   your bank account is not in USD.  

For EU/EEC countries: Company Vat Reg No. : _______________________


Company:___________________________________________________________

Contact Person: ___________________________________________________

Address:___________________________________________________________

City, State, Zip:__________________________________________________

Country:___________________________________________________________

E-Mail Address:____________________________________________________


If You want to speed up the order handling, send also this file via
email to frydendal@mochasoft.dk
