Print out this form and mail, together with a cheque to:-
Octatec Ltd.,
1 Pankhurst Ave, Britannia Village,
London, E16 1UT.
England.
You can now order and pay for the software online

(Or you can print out this form and  send a cheque)
U.K. Company registration number: 
2834582. 
U.K. Vat registration number:
613 3303 88
ORDER FOR JAVA FixGW Interface Package
PRICE:  £  (GBP)  or  e (EUR)  or  $  (USD) per copy
(U.K. orders must add  % VAT, total price £  )
(orders from other EU countries need not add VAT if they are VAT registered)
(otherwise they must add  % VAT, total price e )

Please supply  ___  copy/copies of the JAVA FixGateway Interface Package

I enclose a cheque for  £ __________   or    $ ____________  or    e____________ to cover the order

Computer name where the software will run __________________________ (How to find your computer name)

(Non UK) EU Customers Only: VAT NUMBER _______________________ COUNTRY ___________
(this information is required from non-uk-based EU customers in order for VAT not to be charged)
 
Choose the way you want to receive your order (tick prefered option)

(a) Dispatched by return on 1.44 Mb 3 1/4 inch floppy disk.            [___]
        (add $5.00 or £3.00 or e5.50 for postage/packing)

(b) By private download page (your email address is requried for this) [___]

YOUR ORDER REF (fill in if required): _______________________
 

DELIVERY ADDRESS

Organization:    ______________________________________

Address Line 1:  ______________________________________

Address Line 2:  ______________________________________

County/State:    ______________________________________

Post/Zip Code:   ______________________________________

Country:         ______________________________________
 

eMail:           ______________________________________
(this is required if you are receiving your order via private download page so we can notify you when it's available)