MEDIAMOND TMI - DELUXE SKI JUMP 3 ORDER FORM

Name   : _______________________________________________

Address: _______________________________________________
         _______________________________________________
         _______________________________________________
         _______________________________________________

E-mail : _______________________________________________


I order the following items:

Deluxe Ski Jump 3

 [ ] Euro countries  10 EUR

 [ ] Australia       20 AUD   [ ] Norway        100 NOK
 [ ] Canada          15 CAD   [ ] Poland         40 PLN
 [ ] Czech Republic 300 CZK   [ ] Sweden        100 SEK
 [ ] Denmark         70 DKK   [ ] Switzerland    15 CHF
 [ ] Estonia        150 EEK   [ ] United Kingdom 10 GBP
 [ ] Japan         1500 JPY   [ ] USA            14 USD


DSJ3 Online: 3-Month Subscription

 [ ] Euro countries  10 EUR

 [ ] Australia       20 AUD   [ ] Norway        100 NOK
 [ ] Canada          15 CAD   [ ] Poland         40 PLN
 [ ] Czech Republic 300 CZK   [ ] Sweden        100 SEK
 [ ] Denmark         70 DKK   [ ] Switzerland    15 CHF
 [ ] Estonia        150 EEK   [ ] United Kingdom 10 GBP
 [ ] Japan         1500 JPY   [ ] USA            14 USD


DSJ3 Online: 12-Month Subscription

 [ ] Euro countries  20 EUR

 [ ] Australia       40 AUD   [ ] Norway        200 NOK
 [ ] Canada          30 CAD   [ ] Poland         80 PLN
 [ ] Czech Republic 600 CZK   [ ] Sweden        200 SEK
 [ ] Denmark        140 DKK   [ ] Switzerland    30 CHF
 [ ] Estonia        300 EEK   [ ] United Kingdom 20 GBP
 [ ] Japan         3000 JPY   [ ] USA            28 USD


I want to receive the registration key via:

 [ ] e-mail    [ ] mail


Type of Payment:

 [ ] I have enclosed the cash payment with my order.
     No cheques, please!

 [ ] I have transferred the payment to your bank account
     and enclose a copy of the bank receipt with my
     order.

     Pay To             : Mr. Jussi Koskela
     Bank               : Pohjola Bank Helsinki, Finland
     SWIFT (BIC) -code  : OKOYFIHH
     IBAN               : FI82 5132 0520 0464 34
     Bank account number: 513205-20046434



Date and Signature: ____________________________________

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Send orders and inquiries to us via mail or e-mail.

Mediamond Tmi
Nelikkotie 2 B 44
FI-02230 Espoo
FINLAND

E-mail: sales@mediamond.fi


We usually ship within 24 hours.