Version 3.0

User's Guide

5. Registration

5.3. NetProxy 3.0 Postal/Fax Order Form

Credit card orders may be submitted electronically using our secure web server (details of which are available from http://www.grok.co.uk/ordering.html), or by fax to +44 181 547 2305.

Current pricing information for NetProxy is available from http://www.grok.co.uk/pricing.html

- LICENCE DETAILS -

Your name: …………………………………………………………………………………………………..

The name of your organisation: ………………………………………………………………………

Your E-Mail address (we will send the licence key to this address):

……………………………………………………………………………………………………………………..

Telephone Number: ……………..………………………………………………………………………….

I wish to purchase a licence for: 3 Users / 5 Users / 10 Users / Unlimited Users

- PAYMENT DETAILS -

Card number: ………………………………………………………………………………………………..

Card Expiry date: …………………………………..

Cardholder's Name: ……………………………………………………………………………………….

I fully authorise the sum of: £……………………………………………………… (UK Pounds) to be debited from my credit card by Grok Developments, Ltd.

Signed: …………………………………………………………………….………………. (Cardholder)

- OTHER DETAILS -

VAT Reg. Number (EC-member countries only): …………..……………………………………

Country Code: ……………………………………………………………………………………………….

Please tell us if you would like a VAT receipt to be sent to your postal address.

If you are not paying by credit card, remember to include a cheque, postal order or international money order for the full amount, including VAT if applicable, payable to ‘Grok Developments Ltd’ with your order.

V.A.T. only applies to European purchasers in European Community member countries.

EC purchasers outside of the UK who supply a valid V.A.T. Reg. Number are exempt from paying V.A.T. on goods purchased from the UK.

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