Payment of the Shareware fee
for the ThaiTrainer111 program from WANTANA Software. Price Euro 66.47
I agree to the license agreement enclosed with the shareware software.

[ ] I would also like to order the Shareware-CD. Price=EURO 5,- incl. postage & package.

Name : ................................................................................................................................

Adress : ...............................................................................................................................

Country : ..........................................................    E-mail : ................................................

FAX : ...............................................................     Tel. : ...................................................

[ ] I would like to pay with my credit card:

   [ ] VISA   [ ] MasterCard/EuroCard   [ ] Diners Club   [ ] AmericanExpress not possible [more]

   Card number: __ __ __ __   __ __ __ __   __ __ __ __   __ __ __ __

   Expiry date: __ __ / __ __   Card verification code: __ __ __ important [more]

   Please charge the amount in   [ ] EURO   [ ] US$

[ ] The money has been transferred to the account of:
  Jochen Merz Software, Deutsche Postbank AG NL Essen,
  Kto-No. 6111 00-437, BLZ 360 100 43
  SWIFT/BIC: PBNKDEFF360, IBAN: DE21 3601 0043 0611 1004 37
  Please make sure that the full sum of money will arrive at one time.
  (Most banks offer different charges for different methods, please ask them).

[ ] An International Postal Order is on its way to Jochen Merz Software.

If you choose one of the payment methods listed above, then you can
E-Mail: shareware@j-m-s.com, Fax +49-203-501517 or send the form to us

[ ] Cheque in EURO enclosed.
  Important: the currency has to be EUR, and the bank address printed on the
  cheque has to be resident in Germany!

[ ] International Reply Coupons enclosed (1 IRC = EURO 1.02)

[ ] Cash enclosed (please register letter - for your and our security!)

[ ] A Visa/Citicorp/American Express traveller`s check is encloses.
  Both signatures have to be given, so registered post is better!

[ ] In International Money Order is enclosed. The receiver has to be Jochen
  Merz Software, so nobody else can clear it. No registration required.

If you choose one of the payment methods listed above, then you have to mail them to us:
Jochen Merz Shareware, Kaiser-Wilhelm-Str. 302, D-47169 Duisburg, Germany, Tel. +49-203-501516

.............................................................................................................................
Date, signature