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Purchase Form

Sunday, 25 April, 2004

General Purchase Form

This form allows you to make a payment to Blue Parrot Software for a service or a product not listed within our normal order forms.

1) complete the purchase details first with a description of the purchase, the total amount, and the reference provided by one of our sales agent.

2) Then, complete your personal details and click on the 'Submit' button at the end of the page. You will automatically be transferred to the Worldpay Secure Payment Gateway to validate your Credit/Debit card details.

3) On completion of your payment, you will instantly be e-mailed your purchase receipt. We will get back to you within two working days to let you know your order status.

Alternatively, if you would prefer to pay by post, print this form, complete it and return it to us with your full payment by Cheque, Bank draft or Postal order at:

Blue Parrot Software

P.O Box 769

St Helier , JE4 0RU

Channel Islands

In collaboration with Worldpay, the leader in Internet Credit Card payments, we are pleased to accept the following cards for payments in British Pounds (GBP), US Dollars (US$) or Euros (EUR) :

Purchase Details

1) Complete the Amount, Description and Reference Number fields below :

Order Amount in £: (Do not type any currency sign)

Order Description :

Order Reference :

VAT Registration No :

Personal Details

2) Complete your personal details and click on the "Send Order" button :

Title :

Surname :

Firstname :

Company :

Position :

Address 1 :

Address 2 :

City :

Postcode :

Country :

Telephone :

Fax :

Website :

e-mail :

I have read and agee with the the Terms & Conditions of Sales

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