Mail this form and a check/International postal money order to:

    MochaSoft
    Faksegade 13,1tv
    2100 Copenhagen East
    Denmark

Products:

Mocha W32 TN5250:
  __ single user Licenses of $25 each    = ______
  __ Unlimited Company licens of $250    = ______

Danish Residents add 25% tax             + ______

Total:                                     ______



Wants to receive a receipt by surface mail (yes/no) : _____
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 - If the Check is not drawn on a Danish bank add 70 US for
   extra cost. 

 - Using Danish Checks,  1US = 6.00 dkr

License name: ___________________________________ (will be displayed
                                                  in the help window)

Name:________________________________________  Date:_______________

Company:___________________________________________________________

Contact Person: ___________________________________________________

Address:___________________________________________________________

City, State, Zip:__________________________________________________

Country:___________________________________________________________

Phone Number:______________________________________________________

E-Mail Address:____________________________________________________


If You want to speed up the order handling, send also this file via
email to frydendal@mochasoft.dk