REGISTRATION FORM


Product name: __________________________________________________________

Product #: _____________________________________________________________


Last name: _____________________________________________________________

First name: ____________________________________________________________

Company: _______________________________________________________________

Street and #: __________________________________________________________

City, State, postal code: ______________________________________________

Country: _______________________________________________________________

Phone: _________________________________________________________________

Fax: ___________________________________________________________________

E-Mail: ________________________________________________________________
*** Please do not forget to include your e-mail address. ***
***   ShareIt! will use e-mail to communicate with you.  ***

How would you like to pay the registration fee:
credit card - wire transfer - EuroCheque - cash

Credit card information (if applicable)
Credit card: Visa - Eurocard/Mastercard - American Express - Diners Club

Card holder: ___________________________________________________________

Card No.: ______________________________________________________________

Expiration Date: _______________________________________________________


Date: __________________________________________________________________

Signature: _____________________________________________________________