X/Winteracter - Credit Card Order Form

Print this order form, then FAX it to +44 (0)1785 716413 or mail it to:

Interactive Software Services Ltd.,
PO Box 2822, Penkridge, Stafford ST16 9FA, United Kingdom.

Cardholder's AddressDelivery Address (if different)
Name: _________________________________________
Address:





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_______________________________________

_______________________________________
Post/Zip Code: ____________Country_______________
Name: _________________________________________
Address:





_______________________________________

_______________________________________

_______________________________________
Post/Zip Code: ____________Country_______________

Cardholder's email address: 		__________________________________________________________
VAT (Value Added Tax) registration number :
(non- UK European Union customers only)		__________________________________________________________

The cardholder will be sent an email before the order is processed, listing total cost (including shipping) and
order details. Goods will be despatched on receipt of the cardholder's confirmation that the order may proceed.

QuantitySerial Number(s) (4xxxx)
Target CompilerPlatformNew LicenceUpgrade(Upgrades only)
Lahey Fortran 6.2
Linux/x86
   
Lahey Fortran 8.x
Linux/x86_64
   
Intel Fortran 10.x/11.x
Linux/x86
   
Intel Fortran 10.x/11.x
Linux/x86_64
   
Intel Fortran 10.x/11.x
Mac OS X/x86
   
Absoft Pro Fortran 10.x/11.0
Linux/x86
   
Absoft Pro Fortran 10.x/11.0
Linux/x86_64
   
Absoft Pro Fortran 10.x/11.0
Mac OS X/x86
   

Educational licence(s)?
(available to educational/research institutions, subject to limited redistribution rights)

I accept the standard Terms and Conditions of Sale of Interactive Software Services Ltd.
Please charge my credit card detailed below for the total cost of my order, including shipping.

Card Type: Visa · MasterCard · AmEx (** PLEASE INDICATE CARD TYPE **)
Card Number: _________________________________________________________
Name on card: _________________________________________________________
Expiry Date: ______/______
Security number _____________ (Visa/Mastercard=3 digits, AmEx=4 digits)
Card holder's signature:_________________________________________________________