TSE WWW EDITION ORDER FORM (200909)


      Name: ______________________________________________________

 [Company]: ______________________________________________________

   Address: ______________________________________________________

      City: ____________________________ Postal Code: ____________

   Country: ____________________________ [State]: ________________

     Phone: ________________________ Fax: ________________________

     Email: ______________________________________________________


24-month WWW edition
at EUR 236 each ......................................___ x 236   ______

12-month WWW edition
at EUR 131 each ......................................___ x 131   ______

12-month WWW edition 10 users pack
at EUR 847 each ......................................___ x 847   ______

3-month WWW edition
at EUR 44 each ........................................___ x 44   ______

TOTAL EUR WITHOUT VAT..........................................   ______

If you are within EU and don't have a EU VAT number please     
add 19.6% VAT. If you have a EU number please state it:     VAT   ______

EU VAT number: ________________________________

TOTAL EUR WITH VAT (if applicable).............................   ______


PAYMENT

( ) Check (must be drawn on a French bank in EUR, payable to TBS)
( ) SWIFT (see details at https://www.TBS-internet.com/secure/rib.html )
( ) Credit card (Visa/MasterCard/Amex):

    Number: ________________________________

Expiration: __________                       Verification code: ________



 Signature: __________________________________________________

      Date: ________________________________


SEND TO:
            TBS
            22 rue de Bretagne, 14000 CAEN, France
            Fax: +1-760-284-6216 or +33-2-3178-3187 (write in ALL CAPS)
            email: orders@TBS-satellite.com