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Product : NO REGISTRATION NEEDED
Name : _____________________________________
e-mail : _____________________________________
Credit Card : [ ]MasterCard [ ]VISA [ ]AMEX [ ]DinersClub
[ ]Discover [ ]JCB [ ]CarteBlanche [ ]Optima
Credit Card Number : _____________________________________
Expiration Date : _____________________________________
Name On Card : _____________________________________
Billing Address : _____________________________________
_____________________________________
Please specify the product and quantity :
VasTabs ____
VasTabKey ____
VasSystApplet ____
VasSendMail ____
VasReadMail ____
VasFirewallMailReader ____
VasSpyApplet ____
VasJava2HTML ____
VasObfuLite ____
VasScrollStatus ____
For personal use : ____ copies at $12 each = ______
For professional use : ____ copies at $27 each = ______
For personal use : ____ copies at $50 each = ______ ALL Vasile's programs
For professional use : ____ copies at $100 each = ______ ALL Vasile's programs
Total payment = ______
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