ORION Prices & Order form

The RNG is distributed by ICATT interactive media.
Please print this form, fill it in, sign it and Fax it to ICATT at + 31 20 4206075 or send it with a cheque.
Name: ..................................... Company/
Institution:		 .....................................
Address: ..................................... Zipcode: .....................................
City+State/Province: ..................................... Country: .....................................
E-mail: ..................................... Tel: .....................................
(please print clearly) Fax: .....................................

I wish to order:
1 RNG: 1152 Dutch Guilders ($ 446)*
1 RNG educational: 576 Dutch Guilders ( $ 223)

Shipping in Europe: 20 Dutch Guilders ($ 7,74 ) for each ROBOOT/RNG shipped.
Shipping outside of Europe: 30 Dutch Guilders ($ 11,60) for each ROBOOT/RNG shipped.

Residents of the European Community: please add 19 % BTW (VAT)

Total:...........................................................................
Payment:   Mastercard     Visa   Check (send with this form)
Credit card number:

.............................................................................
Note: if you are using Mastercard, please print the number + 3 extra digits printed on the signature strip - alltogether 19 digits.
Expiration date: .............................................................................
Any comments: .............................................................................

.............................................................................
Signature: .............................................................................
Fax this form to ICATT +31 20 4206075
or send it with a cheque to ICATT - Herenmarkt 10, 1013 ED, Amsterdam, The Netherlands
* Please send us cheques quoting Dutch Guilders. US Dollar prices can vary slightly depending on exchange rates.