
		ORDER FORM
		==========

Please register me as a user of 'Wordmonger', and send me
the registered version of the program.


NAME:	______________________________


ADDRESS:

 HOUSE NAME/# & STREET: _______________________________
             TOWN/CITY: _______________________________
   STATE/REGION/COUNTY: _______________________________
       POSTAL/ZIP CODE: _______________________________
	E-MAIL ADDRESS: _______________________________

NUMBER OF REGISTRATIONS (LICENSES) [ ] 

		    		   AT 10 (UKP) EACH
   			    TOTAL: _____

(PLEASE ADD 1 IF YOU OPT FOR SURFACE MAIL DELIVERY 
 AND YOU RESIDE OUTSIDE OF THE UK.)

DELIVERY REQUESTED BY:	E-MAIL [ ]  SURFACE MAIL  [ ] 

PAYMENT BY:

[ ] CHEQUE  (Made payable to 'Westley Software' Ltd in UK 
	    pounds Sterling). 

[ ] INTERNATIONAL MONEY ORDER  (In UK pounds sterling).

[ ] CREDIT CARD - [ ]-VISA [ ]-ACCESS 
		  [ ]-OTHER:________________

  CARD NUMBER: | _ _ _ _ | _ _ _ _ | _ _ _ _ | _ _ _ _ |
  EXPIRY DATE:  _ _ / _ _ / _ _ 
				
			


POST TO: WESTLEY SOFTWARE LTD, 1FARRAND HOUSE, 
	 LONDON ROAD, STANFORD LE HOPE, ESSEX, SS17 0LE.
TEL: (+44) 01375 672300
FAX: (+44) 01375 673318