InfraRexx Registration/Order Form

User Information

    Name:
          ŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻ
    Address:
             ŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻ

             ŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻ
    Country:
             ŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻ
    Internet/Fidonet E-Mail:
                             ŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻ
      ( ) Yes, please e-mail new InfraRexx releases as uuencoded mail.
          For those that don't have access to FTP or an up-to-date BBS.

InfraRexx Registration

    ( ) Yes, I want to register to InfraRexx. I have included the
        registration fee (DFL 10 or USD 10) with this form.
    ( ) I get free registration because I order the hardware.

Ordering the InfraJoy hardware

    ( ) Yes, I want to order (some of) the InfraJoy hardware interface.
        I want to order the...
        ( ) complete InfraJoy hardware. (DFL 29 or USD 24)

        ( ) transmitter only (receiver can be added). (DFL 19 or USD 16)
        ( ) receiver only (transmitter can be added). (DFL 24 or USD 21)
        ( ) print circuit board (for both) only. (DFL 13 or USD 12)
        ( ) components (for both) only. (DFL 25 or USD 21)
        ( ) transmitter components only (DFL 15 or USD 13)
        ( ) receiver components only (DFL 20 or USD 18)

        ( ) Yes, add connector throughput. (DFL 2 or USD 1 EXTRA)
        ( ) Yes, add extension cable. (DFL 4 or USD 3 EXTRA)

        What is the Amiga model the hardware is used with?
                                                          ŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻ
        ( ) If possible, optimise the hardware for this brand:
                                                              ŻŻŻŻŻŻŻŻŻŻŻŻ
I have read the copyrights and disclaimer notes and agree,


 place, date:                          sign:
              ŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻ       ŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻ
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PLEASE NOTE: (Read "Payment" and "Ordering the hardware" for details)

· Only cash money or EuroChecks are accepted. If you send...
   ...an EuroCheck, fill in DFL (dutch guilders) currency and prices.
   ...cash money, send the USD prices (or the equivalence in your currency).
· Please allow two to six weeks for delivery of the InfraJoy hardware.