CELLARD.COM SOFTWARE ON-LINE ORDER  FORM
FOR SOUTH AFRICA

Your email address:                      

Your I.D. No:                                    

Your Name:                                       
Your Address:                                 
                                                              
Your Town/City:                              
Your Postal Code:                          
Your Province:                                
  
Your Country:                                    


Your Telephone No: (include dialling codes)     

Your Fax  No: (include dialling codes)     

Programs available for purchase:   Ecoloto, Statfoot 32, Ecolotofoot, EcoSuper7, Ecokeno Systems, EcoThunderball, GenPageCbplus , GenCB39

Type In Name of Program Required:        

Amount of Deposit:                        

Print this form before you send it.  This is your order record.
Payment detail for South Africa as follows per program:
Payment by Internet Transfer or direct cash deposit only. Use your name as Deposit Reference.
PRICE:

GENPAGECBPLUS, GENCB39 : R250.00 for Internet download of the program or R270.00 for delivery by postal mail (price for one software)
STATFOOT32, ECOKENO: R210.00 for Internet download of the program or R230.00 for delivery by postal mail (price for one software)
ECOLOTO, ECOLOTOFOOT, ECOTHUNDERBALL: R175.00 for Internet download of the program or R195.00 for delivery by postal mail (price for one software)

Bank:    ABSA
Account Name:    J Small
Account Number:   1283920018
Account Type:        Cheque 

Fax proof of Internet Transfer/Direct cash deposit to:  Joan Small at  0867133282  (South  Africa only)
Address:  P.O. Box 12613, N1 City, 7463       Contact:   Cell  072 2162973

You will be contacted by Eric Cellard of Cellard.com on verification of your payment.

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