www.ContaminatedLAND.co.uk

PLEASE PRINT THIS ORDER FORM OUT AND POST IT TO : -
'Bolux on a Disk'
www.ContaminatedLAND.co.uk
120 Grandison Road
London SW11 6LN England

I would like to order a copy of 'Bolux' for my personal use.
Please find enclosed with this order form (which is classed as 'an invitation to treat', i.e we can reserve the right to refuse to sell to you)

A cheque for ? 12 (Twelve pounds / Twenty US dollars / Twenty Euros)
made out to Layla Resources Ltd and enclosed together with this order form.
I do / don't require a VAT invoice (our VAT No is 653 2427 47)
For which I will be granted a perpetual license for my own personal copy of 'Bolux'.

I confirm that the email address I am using is correct and belongs to me ! , should my email address change I will notify you of my new address, so that you can notify me when a new version of 'Bolux' hits the Web

Title (Mr / Ms / Mrs etc)..........................................................
First Name..............................................................................
Surname..................................................................................
Address..................................................................................
Address..................................................................................
Town/City........................................ Postcode.......................
Email......................................................................................
Signature...................................Dated (........./........./...200...)

to suggest improvements.

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URL: http://www.ContaminatedLAND.co.uk/send-now.htm
[Page created: 11th Nov 65, Last Update: 29th April 2000]
Copyright ? 1996, Layla Resources Ltd, All Rights Reserved