

1. User information:

Name: ___________________________________________________________
Address: ________________________________________________________
City: ___________________ State: _____________ ZIP: _____________
Country (if other than U.S.A.):__________________________________
Phone number: (___)______________ Date (MM/DD/YY): ____/____/____
E-mail address (optional): ______________________________________

2. Shipping and Handling (check one):

__ Mail 3.5'' DS/HD disk, user name and ID to address above.

3. Payment and fees:

Fees are in U.S. dollars, please do not send cash. Checks and
money orders must be made payable to GJC Software.
Select form of payment (check one):

__ Enclosed check or money order in U.S. dollars


4. Check all that apply and fill in the blanks:

__ One registered copy of EZView Pro ......................$25.00
__ U.S. Shipping and handling ..............................$5.00
__ Non U.S. Shipping and handling .........................$12.00
__ New Jersey residents add 6% sales tax...................$ 1.80

Total:.....................................................$_____

5. Mail this form together with payment to:

   GJC Software
   340 Grand Central Pky.
   Bayville, NJ 08721
   USA
	
  
