Payment of Shareware fee
for the program DeutschTrainer111 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 : ..........................................................    eMail : ...........................................................

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

[ ] Please charge 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 amount of money will actually arrive.
  (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
eMail: 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 Travellers Cheque is enclosed.
  Both signatures have to be given, so better register letter!

[ ] 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