Order for Web Image Protector 1.0

Price in US$ : $39.95

If you would like to purchase a license for Web Image Protector 1.0, you can 
order online at:

http://www.corsac.com/purchase/wip.htm

If you are not yet online, you can place your order with our customer 
service team by phone, fax or postal mail.

Please print out the following form, and fax or mail it to:

share-it! - element 5
Vogelsanger Strasse 78
50823 Cologne, Germany

Phone: +49-221-31088-20
Fax: +49-221-31088-29
E-Mail: sales@shareit.com

US and Canadian customers may also order by calling toll-free 
1-800-903-4152(only for ordering).

US check and cash orders can be sent to our US office at:
share-it!
9625 West 76th Street, Suite 150
Eden Prairie, MN 55344, USA
Phone: +1 952 646-5747 (for calls from outside the U.S.) or +1 800 903 4152 (for calls from inside the U.S.)
Fax: +1 952 646-4552

*** ALL CHECKS SENT TO THE U.S. OFFICE MUST BE MADE 
PAYABLE TO:  "ShareIt! Inc." ***

Registration Form for Web Image Protector 1.0

Program-ID : 145417

Last Name:
_______________________________________

First Name:
_______________________________________

Company:
_______________________________________

VAI-ID-No. (if applicable)
_______________________________________

Address:
_______________________________________

Postal Code and City:
_______________________________________

Country:
_______________________________________

Phone:
_______________________________________

Fax:
_______________________________________

E-Mail:
_______________________________________

How would you like to receive the registration key/full version?

e-mail - fax - postal mail


How would you like to pay the registration fee:

credit card - debit card - wire transfer - check - cash

Credit/Debit Card Information (if applicable)

Credit Cards: Visa - Eurocard/Mastercard - American Express - Diners Club 

Debit Cards: Switch/Maestro - Solo

Card Holder: ________________________________

Card No.: ___________________________________

Expiration Date: ________

Start date(only Solo/Switch/Maestro): ________

Issue Number(only Solo/Switch/Maestro): ________

Date and Signature: ___________________________
