Print out this form and fax/mail/email it to the office nearest you

ShareIt! Inc. Suite 1800 Chapel Hill Professional Center Greensburg, PA 15601-8019 USA Phone: 724-853-6618 Fax: 724-850-8187 Email: register@shareit.com

element 5 AG / ShareIt! Vogelsanger Strasse 78 50823 Koeln Germany Phone: +49-221-31088-20 Fax: +49-221-31088-29 Email: register@shareit.com

Registration Form

rptMart for CR (10 Session) - #131131   Cost: US$ 560.00

Last name: ___________________________________

First name: ____________________________________

Company: ____________________________________

Which name should the product be registered to? (circle one)
My Name - Company Name

Street and #: ______________________________________

City, State, Zip code: ________________________________

Country: _______________________________________

Phone: ____________________ Fax: ____________________

Email: ______________________________________

*** Please double check your email address - we will use it to contact you.

How would like to receive the registration key? (circle one)
Email - Fax - Postal mail

How would you like to pay the registration fee? (circle one)
Credit Card - Wire Transfer - EuroCheque

Credit Card Information (if applicable)

Credit card (circle one):
Visa - Eurocard/Mastercard - American Express - Diners Club

Card holder: ________________________________

Card No.: ___________________________________ Expiration Date: ________

Signature: ___________________________

Date: ___________________________