Registration Order Form

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Single User RS FTP Software Registration Request Form

Print and fill out this form, then either post or fax as per the details provided below. Alternatively visit our web site and register on-line at: http://www.research-systems.com/rsftp/ftpclient.html.

Name:
          _________________________________________
Address:
          _________________________________________

          _________________________________________
Town:
          _________________________________________
State/Zip:
          _________________________________________
Country:
          _________________________________________
E-mail:
          _________________________________________

User Name and User Number (Must be as shown in the Registration Screen):

          ________________________________________________________________

Please register a Single User RS FTP (File Transfer Protocol Client) Program with the above details.

Payment by Credit Card:
                         [ ] Bankcard
                         [ ] Visa
                         [ ] MasterCard
                         [ ] American Express

Please debit my card number:
                           ___________________________________________________
Expiry Date:
                           ______________________________
Name as shown on card:
                           ______________________________
Signature:
                           ______________________________

Note: With the exception of American Express cards, which are billed in US dollars, the amount charged will be the Australian dollar equivalent of US$17.95. The amount shown on the card statement may not, therefore, be exactly US$17.95.

Payment by other method:
                    [ ] Cash US$18.00 (Not recommended)
                    [ ] Cheque to the value of US $22.95 (Bank charge applies to foreign currency cheques).
                    [ ] Direct deposit to the author's bank account

Customers paying by credit card or direct deposit may fax the completed form to: (+61) 3 9228 1966 or post to the address below.
Bank account details are available on request either by fax as above or by e-mailing research@research-systems.com .
Customers paying by cheque made out to Kevin Acres, through the mail, may send the completed form along with the appropriate remittance to:

    K. Acres
    c/o Research Systems Pty. Ltd.
    15/1540 Main Road
    Research
    Victoria 3095
    Australia