Orderform for LED-Package v1.0
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Print out and send to :

	PMS System Software
	Pierre Simon
	Eibenkamp 16
	45481 Mlheim / Ruhr
	Germany
        Telefax : 049 - (0)208 - 461642

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Program : LED-Package ___ w/o source     ($15)

                      ___ incl. source   ($25)
	  

Last Name   : ______________________________________

First Name  : ______________________________________

Company     : ______________________________________

Street, Nr. : ______________________________________

City, ZIP   : ______________________________________

Land        : ______________________________________

Phone       : ______________________________________

Fax         : ______________________________________

E-Mail      : ______________________________________

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Deliver the software via ____ e-mail 	
                         
                         ____ postal mail

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I want to pay            ____ with creditcard

                         ____ money order
           
                         ____ EuroCheque 

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Creditcard-Information:
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Card            : ___ Visa             ___ Euro-/Mastercard 
             
                  ___ American Express ___ Diners Club

Card's owner    : ___________________________________

Card's number   : ___________________________________

Expiration Date : ___________________________________

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Date / Sign  ______________________________