BAxBEx Software - Order Form

Please print clearly and mail or fax to:


 BAxBEx Software	      Fax: ++49 23 69 - 24 80 92
 Erneeweg 39		    Phone: ++49 23 69 - 20 00 74
 			    email: order@baxbex.com
 46286 Dorsten
 Germany


       First name : ______________________________________

        Last name : ______________________________________

          Company : ______________________________________

   Street Address : ______________________________________

 City, State, ZIP : ______________________________________

          Country : ______________________________________
        
            Phone : ______________________________________

              Fax : ______________________________________

            Email : ______________________________________



What would you like to order?

[ ] Folder Shield      ($19.95)
[ ] Folder Shield PRO  ($49.95)
[ ] CryptoMite         ($29,95)
[ ] Shell Picture      ($29.95)
[ ] Folder Pilot       ($19.95)
[ ] FolderBox Pro      ($15.00)
[ ] OpenExpert         ($19.95)

[ ] bxAutoZip for Outlook           ($19.95)
[ ] bxAutoZip for Outlook Express   ($19.95)
[ ] noHTML for Outlook Express      ($19.95)
[ ] Outlook Security Plus           ($19.95)

[ ] bxBundle           ($69.95)
   
bxBundle includes Folder Shield, CryptoMite, Shell Picture, 
Folder Pilot, bxAutoZip for Outlook and FolderBox Pro.

Would you like to get a Backup CD-ROM?

[ ] Backup CD-ROM       (+$12.00 per order)


Payment

[ ] Creditcard          	Card Holder: ______________________
    [ ] Mastercard/Eurocard
    [ ] VISA			Card Number: ______________________
    [ ] American Express
    [ ] Diners Club	        Valid until: ______________________

[ ] Cash (Money Enclosed)
[ ] Check or Money Order (+$10.00 handling fee)

    (Make Check or Money Order Payable To: 
    BAxBEx Software - Carsten Paasch)
    
[ ] Bank transfer/wire

    Volksbank Dorsten eG, Germany
    
    Bank number:	426 623 20
    Account owner: 	BAxBEx Software - Carsten Paasch
    Account number:	934 434 401
    
    IBAN: DE78 4266 2320 0934 4344 01
    BIC/SWIFT: GENODEM1DST
 


Date / Signature ___________________________