MEDIAMOND TMI - DELUXE SKI JUMP 2 ORDER FORM

Name   : _______________________________________________

Address: _______________________________________________
         _______________________________________________
         _______________________________________________
         _______________________________________________

E-mail : _______________________________________________


I want to receive the registration key via:

 [ ] e-mail    [ ] mail


Registration fee:

 [ ] Euro countries   7 EUR

 [ ] Australia       15 AUD   [ ] Norway         70 NOK
 [ ] Canada          10 CAD   [ ] Poland         30 PLN
 [ ] Czech Republic 200 CZK   [ ] Sweden         70 SEK
 [ ] Denmark         50 DKK   [ ] Switzerland    11 CHF
 [ ] Estonia        110 EEK   [ ] United Kingdom  7 GBP
 [ ] Japan         1000 JPY   [ ] USA            10 USD


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             : Jussi Koskela
     Bank               : Pohjola Bank Helsinki, Finland
     SWIFT (BIC) -code  : OKOYFIHH
     IBAN               : FI82 5132 0520 0464 34


Date and Signature: ____________________________________

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

Mediamond Tmi
Ullantorppa 4 A 9
FI-02750 Espoo
FINLAND

E-mail: sales@mediamond.fi


We usually ship within 24 hours.