On-line Subscription

If you wish to subscribe to NMCRL-WEB/ NMCRL-DVD, simply fill in this form and submit it on-line.

(* = mandatory fields)

Organisation/Company:

Dept.:

Contact:

Address (Street & No):

P.O. Box:

City:

State/Province:

Zip/Postal Code:

Country:

Phone:

Fax:

E-Mail:

Number of subscriptions*	Media	Licenses	Prices
NMCRL-WEB :
	WEB	1 single user	760 EUR
	WEB	1 to 5 concurrent users	1550 EUR
	WEB	1 to 20 concurrent users	3000 EUR
NMCRL-DVD :
	DVD	1 single user	850 EUR
	DVD	Network version 1 to 5 users	1700 EUR
	DVD	Network version 1 to 20 users	3400 EUR
NMCRL-PACK (=WEB access + 6 DVD updates per yearly subscription)
	WEB + DVD	1 single user	975 EUR
	WEB + DVD	1 to 5 concurrent users / 1 to 5 network users	1950 EUR
	WEB + DVD	1 to 20 concurrent users / 1 to 20 network users	3800 EUR

Total amount in EUR (€):

Payment Methods* :

Bank transfer to NAMSA's account with BCEE in Luxembourg:
IBAN*: LU14 0019 1007 7845 4000 BIC*: BCEELULL

*	IBAN = International Bank Account Number
*	BIC = Bank Identifier Code / SWIFT Code

Bank cheque to the order of NAMSA-Finance Division

EuroCard/MasterCard*

*see NOTE below

Visa Card*

Comments:
	Date:

*	We accept the General Conditions Unauthorized use, duplication or distribution is strictly prohibited

NOTE for Credit Card Payment:
Customers wishing to pay by Credit Card, should print

this form or the PDF form (Adobe Acrobat), fill it in and return it by fax or mail.

Holder:

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

Number:

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

Expiration:

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

CVV2 no.:

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

On the back of the card, in the signature area, is your credit card number followed by the 3 digit CVV2 security number

Signature:

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

	+352.3063.4748
	NATO Maintenance & Supply Agency (NAMSA) Co-operative Logistics Programme (LZ) - NMCRL L-8302 Capellen Luxembourg