Imië i nazwisko
Ulica
Kod Miasto
Poland
Phone: +48-kierunkowy-numertelefonu
Email: adres@mail.pl

[Aktualna data]


To:
W.F.M.H.
c/o Marcin Orlowski
ul. Radomska 38
71-002 Szczecin
Poland
Email: reg-pl@vapor.com


Registration
============

Product                           Quantity        Total
-----------------------------------------------------------
AmIRC                           SZT * @ _____  =  KWOTA ZL
AmigaNCP                        SZT * @ _____  =  KWOTA ZL
AmTALK                          SZT * @ _____  =  KWOTA ZL
Voyager 3.x                     SZT * @ _____  =  KWOTA ZL
AmFTP                           SZT * @ _____  =  KWOTA ZL
AmTelnet                        SZT * @ _____  =  KWOTA ZL
AmTerm                          SZT * @ _____  =  KWOTA ZL
AmTelnet/AmTerm                 SZT * @ _____  =  KWOTA ZL
WFMH LocalePL v3!               SZT * @ _____  =  KWOTA ZL
                                                 ==========
                                       Subtotal:  LACZNIE ZL
                                                 ==========
                  RAZEM_SZTUK units, discount -:  ZNIZKA ZL
                                                 ==========
                                    Total price:  RAZEM ZL


Shipping: via [SPOSOB_DOSTARCZENIA]

Uwagi:



I agree to the software license as presented by the registration program.



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                Data                                    Podpis