KAY ORDER FORM

Please make it possible to correctly interpret you writing / printing !

Your name :
Company :
Address :
  ,  ,  
City etc :
  ,  ,  
Country :

Telephone Nr :
Fax Nr :
Email address :
Only for non-Dutch EC customers, VAT number :

What type of CNC milling machine do you use ? :

How did you learn about KAY ?
« » Direct mail
« » Advertisement, in ...
« » Article, in ...
« » Internet search
« » Via current user ...
« » Other, please specify: ...

All prices in European Euro currency (prices for direct orders).

« » KAY                                    (EUR    190.00)   =

Shipment, check one of three:
« » Fedex courier, within EC               (EUR     30.00)   =
« » Fedex courier, USA, Canada, Mexico     (EUR     40.00)   =
« » Fedex courier, rest of the world       (EUR     55.00)   =

Only for EC customers without a VAT number and for Dutch customers:
« » Add 19 % VAT sales tax.                                  =
								   -----------  +
Total amount due:

Credit Card to be used.
Check one of two:
« » MasterCard
« » VISA

Cardholder name and initials: ....
Credit Card number : .... .... .... ....
Expiration date : ../..
Card Validation Code (CVC) : ...
(a three number code, written on the back of the card, right of the card number).

MasterCard only:
Address of Cardholder :
ZIP (postal) Code :
Country :

By Signing I agree to be bound to the terms of the license agreement, and I agree to pay the total amount as specified using my credit card.
Cardholders signature:

Print out this form and fax it to Delft Spline Systems.

Delft Spline Systems
PO.Box 2071, 3500 GB Utrecht, The Netherlands
Tel +31 30 296 5957, Fax +31 30 296 2292.
To be reached by email: info@spline.nl