Registration form for Explor2000

Program No.: 101091 (single license)

Last name: ___________________________________

First name: ___________________________________

Company: ____________________________________

Street and #: ______________________________________

City, State, postal code: ________________________________

Country: _______________________________________

Phone: _____________________________________

Fax: ________________________________________

E-Mail: ______________________________________

(Note: Email is the way by which you will receive important information such as your registration key, so please make sure that you give your complete and correct Internet e-mail addre ss (e.g., otherwise we will not be able to communicate with you.)

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

e-mail - fax - postal mail

How would you like to pay the registration fee of $32 ?

credit card - wire transfer - EuroCheque

Credit card information (if applicable)

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

Card holder: ________________________________

Card No.: ___________________________________

Date of Expiration : ___________________________________

Date / Signature ___________________________