You must provide the following information when ordering by phone, FAX, or e-mail.
We recommend that you retain a hard copy of this information for your records.
Your Name:
Your Organisation:
Billing Address (the address your credit card bill is sent to)
Street:
City:
State:
Zipcode:
Country:
Mailing Address (if different than billing address)
Street:
City:
State:
Zipcode:
Country:
Work Phone Number:
Home Phone Number:
E-mail Address:
Items to Order (please indicate which)
Title: AGIS for Windows Registration
Price: US$49.00
Title: AGIS for Windows Mapserver for a website
Price: US$125.00
Title: AGIS Map of the World CD ROM
Price: US$42.00 + US$5.00 p&h
Credit Card Information
Type: Visa,Mastercard,American Express,
Discover Card,Eurocard
Account Number:
Expiration Date:
Total Dollar Amount:
I authorize RegNet to bill my credit card and agree to pay the total amount according to my card issuer agreement.
Order by telephone in the US Toll-free: 1 800 WWW2REG (1 800 999-2734)
International telephone orders: +1 (805) 288-1827
Order by email to RegNet@swregnet.com
Updated 6 January 2004