Wiering Software  /  BMT Micro printable order form
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   Please print this form and fill it out clearly, then mail or fax it:

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   Mail orders:                     Fax orders:

      BMT Micro                        (910) 792 1889
      PO Box 15016
      Wilmington, NC 28408
      U.S.A.

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   For ordering and general ordering questions, send an e-mail to:

      orders@bmtmicro.com

   We accept Visa, Mastercard, Discover, American Express, Diners Club,
   Carte Blanche, Cashiers Check, Personal Check. Personal checks are
   subject to clearance. Euros, Sterling, and US Currency is welcome
   but please send by registered mail, return receipt requested. We
   cannot be liable for lost cash sent through the mail

   If you reside in a country with an unconvertible currency please
   contact us for alternatives.

   For more information on ordering from Germany, please read the
   information below.

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   Check product:                                            Price:

      12910001   [ ]  Super Worms registration code             $ 12.50

      12910002   [ ]  Charlie the Duck (Charlie I) code         $  7.50

      12910000   [ ]  Charlie II registration code              $ 15.00

      12910004   [ ]  Expansion Pack for Charlie II             $ 15.00

      12910003   [ ]  Olaf & Elmar registration code            $ 19.95


                 [ ]  CD-ROM shipping (*)                       $ 10.00

      (*)  Optional, use this if you would like to have the
           product sent to you on CD-ROM. If not, download it
           yourself from http://www.wieringsoftware.nl/


   Subtotal:                                                  $ _______

   If two or more games, substract 12.5% discount:            $ _______

   North Carolina residents add 7% Sales Tax:                 $ _______

   Total amount enclosed:                                     $ _______


   Name: ______________________________________________________________

   Address: ___________________________________________________________

            ___________________________________________________________

   City: ______________________  State/Province: ______________________

   Zip/Postal Code: ___________  Country: _____________________________

   Phone: _____________________________________________________________

   Fax:   _____________________________________________________________

   E-mail address:   __________________________________________________

   Alternate E-mail: __________________________________________________



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   Payment Method (circle):

   CASH         /  CHECK          /  MONEY ORDER  /  DEUTSCHE BANK 

   VISA         /  MC             /  DISCOVER     /  AMERICAN EXPRESS

   DINERS CLUB  /  CARTE BLANCHE  /  JBC          /  EUROCARD 

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   For check or money order payments:

      *  Please make check or money order payable to "BMT Micro"

      *  All checks or money orders in US Funds only  

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   For credit card payments:

      Credit card number: _____________________________________________

      Expiration Date:    _____ / _____

      EXACT Name on Card: _____________________________________________


      Signature:          _____________________________________________
  

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                          ORDERING FROM GERMANY
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   Persons in Europe wishing to order shareware may also transfer funds
   into our account with Deutsche Bank. Once the money is deposited you
   may either fax a confirmation to us with proof of deposit or wait
   until Deutsche Bank notifies us of the transaction (usually 10-18
   business days). Account information is as follows:

      Deutsche Bank / Frankfurt Branch
      Empfänger: Thomas Bradford
      Konto-Nummer: 0860221
      Bankleitzahl: 500-700-10

   When you make the transfer, be sure to put your name and the program
   you are registering on the transfer.

   It is very important that you send us a completed order form by
   either email or fax if you deposit money into this account for a
   registration. Fill the order form out as usual except in the credit
   card number field put "DEUTSCHE BANK". We will file the order and
   use it to match against the deposit information we receive from the
   bank.

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                               IMPORTANT!
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   When you fax or mail us your order form, we will reply to the email
   address above with an acknowledgement. If you do not get an
   acknowledgement within 7-10 business days for mail orders, please
   send your order again in case it was lost. This extra bit of caution
   can save a lot of confusion.

   If you are concerned that your order is taking too long to process,
   feel free to check with us about the status of your order. It's
   important to all of us that you feel safe doing business with our
   company and please feel free to suggest ways we can improve our
   service to you.

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