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		  ATOMS, SYMBOLS AND EQUATIONS v1.0 ORDER FORM
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     	Please complete all sections of this form.  YOU MUST OBTAIN THE
	APPROPRIATE LICENCE FOR YOUR USE.
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	What type of licence do you require?  Please tick one box. 
 
     	For use on a SINGLE computer 			  16 - 00  [ ]
     	For use on up to 6 machines on 1 site	 	  38 - 00  [ ]
	Site licence for use on more than 6 machines	  56 - 00  [ ]
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	Purchasers name and address:

	Name   .................................

	School (if applicable):
	
	........................................

	Address ................................

		................................	

		................................

	Email(if available)  .....................................
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	Do you wish to receive registration by:  Email [  ]    Post [  ]
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	Please send this form, together with your payment to:

	R. Le Couteur
	47 Daffodil Way      Cheques/PO's payable to: R. LE COUTEUR
	Chelmsford				
	Essex
	CM1 6XB		Email: RayLec@compuserve.com
			Tel:   01245 466078
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    	I understand that Atoms, Symbols and Equations is provided AS IS
	and without warranty of any kind, either express or implied. 
	I confirm that it will be used according to the licence.
    	

  	       		Signature: .........................
 