Fax Order Form

To place a fax based order simply complete details below, print this page (or print a blank and hand enter as you desire) and fax to Scintillating Graphics on +61 7 55924 343. You are not required to use this form, however if you fax us an order please ensure that all of the details that are on this form are included in your order.

I wish to purchase the following products as specifiied below:

Name:

Email:

Shipping Address:

Products Ordered:

copies of VRMLmagic Version 1.0 at $199.00 USD (US Dollars) each.

Platform:

Microsoft Windows (98, Me, NT, 2000, XP)

Delivery Method:

Online (Download) - $0.00 USD

Physical Package (CD copy) - $15.00 USD

Payment by:

VISA

Mastercard

Bankcard

Credit Card Number:

Cardholders Name:

Card Expiry Date:

Cardholders Signature:

Total Cost: (ie. amount being paid)

$ USD

On receipt and processing of this order you will receive an acknowledgment email (sent to the address you specify) this message will include the necessary links/information regarding how your software will be delivered (ie. for download you will be given link to download page, for physical delivery you will receive delivery details).