PLEASE PRINT THIS PAGE, FILL IN AND SEND TO THE ADDRESS PROVIDED BELOW _____________________________________________________________________ BMTMicro Order Form Last revised December 3rd, 2001 _____________________________________________________________________ Mail Orders To: BMT Micro, Inc. PO Box 15016 Wilmington, NC 28408 USA Voice Orders: 8:00am - 6:00pm EST (-5 GMT) (800) 414-4268 (orders only) (910) 791-7052 Fax Orders: (910) 350-2937 24 hours / 7 Days (800) 346-1672 24 hours / 7 Days via Internet: orders@bmtmicro.com http://www.bmtmicro.com Ordering and general ordering questions: Via Email: bmt@bmtmicro.com Via AOL: bmtmicro Technical Support Questions: webassist@bmtmicro.com (Kim Valentine) We accept Visa, Mastercard, Discover, American Express, Diners Club, Carte Blanche, Cashiers Check, Personal Check. Personal checks are subject to clearance. Eurochecks in DM are welcome. DM, Sterling, and US Currency is welcome but send only by registered mail, return receipt requested. We cannot be liable for lost cash sent through the mail. If you reside in a country with an unconvertible currency please contact us for alternatives. Purchase orders are welcome, subject to approval. The minimum amount is $250.00 US. Information for our German customers is explained in the last paragraph of this order form. _____________________________________________________________________ Company:_____________________________________________________________ Name:________________________________________________________________ Address:_____________________________________________________________ _____________________________________________________________ City: _______________________________State/Province: ________________ Postal/ZIP Code: ____________________Country:________________________ Phone:_______________________________________________________________ Fax: _______________________________________________________________ E-Mail #1____________________________________________________________ E-Mail #2____________________________________________________________ Product Quantity Price Number of copies _________________________ ______________ ________________ x ____________ = + $ _______ x ____________ = + $ _______ x ____________ = + $ _______ x ____________ = + $ _______ North Carolina Residents add 6.5% Sales Tax $ _______ Shipping and Handling (no quantity limit / see below) $ _______ Registration Shipping Options: ------------------------------ Email - Subject to Credit Card Verification Free CD and Diskette Shipping Options: --------------------------------- 2-3 Day Priority, USA Only ................ $ 5.00 US Global Priority, NON-USA Only.............. $ 10.00 US Airborne Overnight USA Only ............... $ 18.00 US Total: $ _______ For credit card payment only Circle one: VISA / Master / Discover / American Express / Diners Credit card number: _____________________________________________ Expiration date: ________________________________________________ Authorization signature: ________________________________________ ORDERING FROM INSIDE GERMANY ONLY ================================= Persons in Germany wishing to order shareware may also transfer funds into our account with Deutsche Bank. Once the money is deposited you may either fax a confirmation to us with proof of deposit or wait until Deutsche Bank notifies us of the transaction (usually 10-18 business days). Account information is as follows: Deutsche Bank / Frankfurt Branch Empf„nger: Thomas Bradford Konto-Nummer: 0860221 Bankleitzahl: 500-700-10 When you make the transfer, be sure to put your name and the program you are registering on the transfer. It is very important that you send us a completed order form by either email or fax if you deposit money into this account for a registration. Fill the order form out as usual except in the credit card number field put "DEUTSCHE BANK". We will file the order and use it to match against the deposit information we receive from the bank. IMPORTANT! ---------- When you email us your order form, we will reply with an acknowledgement. If you do not get an acknowledgement within 24 hours please send your order again in case it was lost. This extra bit of caution can save a lot of confusion. If you are concerned that your order is taking too long to process, feel free to check with us about the status of your order. It's important to all of us that you feel safe doing business with our company and please feel free to suggest ways we can improve our service to you.