Fax Order Form for Verbix (SWREG #92075220572)

  1. Before ordering Verbix, please, download the newest "evaluation" version of Verbix software (http://www.verbix.com/download.asp) and install it on your computer.
  2. By filling in and faxing this order you will get by email a Verbix user name and a password.
  3. Enter the user name and the password in Verbix startup screen to disable all evaluation version limitations from Verbix.

To order by fax using a credit card, please print out this document, complete it and fax to Soft Shop.

North America:
(888) 761-8826 toll free or else (978) 336-0331

Belgium 0707 03334

UK 0870-133-1269
Finland 0925 360011
Switzerland 0127 42077
New Zealand 09 3531352
Ireland 0163 35015

Netherlands 0208 845094
France 0153 010904
Australia 0294 754008
Germany 0692 5577 989
Italy 0295 441197

 

The following numbers are for manually dialled fax machines only. When asked for the receiving number enter 441297553366 - do not leave voicemail messages please. Please allow one or two working days for faxes to be collected.

China: Beijing
010-852 82210

China: Ghuang Zhou
020-86641227

Hong Kong
0285 99000

India: Mumbai
022-3051875

India: Gandhinagar
027-1238301

India: Surat
0261 671540/1

India: Baroda
0265-335224/40

Norway
032-82-2299

Malaysia
03-632 2897

Singapore
02720433

Taiwan
0287 800374/5/6/7

Shanghai
021-545 91541

Brasil: Brasilia
061 322 4576

Ship-To Name & Address:

First/Middle Name:

Last Name:

Company name:

Address:

 

 

 

Phone + Fax

Your email address - in capitals:

Card number (MC, Visa, Amex, Discover, Switch, Delta, Eurocard, Diner's):

Expires- Month: Year::

Start Date (Diners only):
Issue Number (Switch only):

Credit Card Holder's Name & Address for verification: Do NOT enter the BANK's name or address in the fields below. Enter the address where the cardholder receives the statements. (Only fill out the spaces below if the credit card holder's name or address is DIFFERENT from the Ship-To name and address entered in the spaces above.)

Name on the card:

Company name:

Address:
(if different to above)

 

 

 

Order Details

Item

Price

Quantity

Subtotal

Verbix registration key delivery by email*.
(* Read the delivery details at the top of this fax)

$30US

 

 

Fax handling fee:

$3

1

$3

 Total Order Amount in US Dollars 

 

Card holder will pay card issuer above amount pursuant to cardholder agreement

 

Signature: __________________________________