Please print out the following form, and fax or mail it to: 
ShareIt!
element 5 AG 
Vogelsanger Str. 78                  Phone:     +49-221-31088-20
50823 Cologne                        Fax:       +49-221-31088-29
Germany                              E-Mail:    service@shareit.com
Registration Form for Alchemy Remote Executor

Program-ID* : _____________
*Please use the following Program ID:
'300046785' (Single License, $50 US)

Last Name: _______________________________________

First Name: _______________________________________

Company: _______________________________________

VAI-ID-No. (if applicable) _______________________________________

Address: _______________________________________

Postal Code and City: _______________________________________

Country: _______________________________________

Phone: _______________________________________

Fax: _______________________________________

E-Mail: _______________________________________

How would you like to pay the registration fee: __________________
(credit card - wire transfer - check - cash)

Credit Card Information (if applicable)
Credit Cards: Visa - Eurocard/Mastercard - American Express - Diners Club

Card Holder: ________________________________

Card No.: ___________________________________

Expiration Date: ________

Date / Signature: ___________________________