Please print out the following form, and fax or mail it to:

for US orders:
ShareIt! Inc.
PO Box 844
Greensburg, PA 15601-0844

U.S.A.
Phone: 1-800-903-4152
Fax: 724-850-8187		 for international and european orders:
ShareIt!
element 5 AG
Sachsenring 69
50677 Koeln
Germany
Phone:+49 (0)221-2407279
Fax: +49 (0)221-2407278

GutmannSoft ScreenShot Order Form
Program No.: 101192
______________________________________________________

First Name, Last name:
Street and Nr.:
City, State, postal code:
Country:
Phone:
E-Mail

How would you like to pay the registration fee of ?

credit card
 wire transfer
 cheque
 cash

Note: Please do not send eurocheques in US$. We can only accept eurocheques in DM .
Please make checks payable to ShareIt! or element 5 AG (corresponding to the address)

Credit card information (if applicable)

Credit card:
Visa
 Eurocard/Mastercard
 American Express
 Diners Club

Card holder:
Card No.:
Date of Expiration:

Date / Signature:___________________________