================================================================== Ong Utilities I registration form ONG Utilities I is Copyright (c) 1997 by ONG SoftWare. All Rights Reserved. ================================================================== Note: Each registration of ONG Utilities I comes with only one license for ONG Utilities I. Mail Orders To: BMT Micro PO Box 15016 Wilmington, NC 28408 U.S.A. Voice Orders: 8:00am - 7:00pm EST (-5 GMT) (800) 414-4268 (Orders only) (910) 791-7052 (Orders / Order Inquires) Fax Orders: (910) 350-2937 24 hours, 7 days a week (800) 346-1OS2 24 hours, 7 days a week Online Orders via BBS: (910) 350-8061 10 lines, all 14.4K (910) 799-0923 28.8k v.FC via Compuserve: 74031,307 via Internet: bmt@wilmington.net via AOL : bmtmicro We accept Visa, Mastercard, Discover, American Express, Diner's Club, money order, cashiers checks, and personal checks. We also accept DM and British currency via registered mail. Personal checks are subject to clearance. Name: ____________________________________________________________ Company: ____________________________________________________________ Address: ____________________________________________________________ ____________________________________________________________ City: _______________________ State/Province: __________________ Country: ____________________________ Postal Code: __________________ Phone: ____________________________________________________________ Fax: ____________________________________________________________ Email: ____________________________________________________________ Product Price Quantity Total -------------------------------------------------------------------- ( Funds below specified in US dollars ) _ONG Utilities_I________________ $_14.95__ x ________ = $____.___ Subtotal: $____.___ North Carolina residents, please add 6% sales tax: +$____.___ Total: $____.___ Shipping (check one): ___ Email ___ 1st Class Mail For credit card payment only: Circle one: VISA / Master / Discover / AMEX / Diner's Club Credit card number: _____________________________________________ Expiration date: ___/___ Authorization signature: _____________________________________________