| |
|
Name:* |
|
Company:* |
|
Telephone*: |
|
Email:* |
|
Reconfirm Email:* |
|
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Product* |
| |
Infopay
|
| |
InfopayLite
(1 Company) |
| |
InfopayLite
(2 Company) |
| |
Year(s):*
(eg. 06-08, 09 etc) |
Old Computer I.D:* |
|
Old Computer Description:*
(eg. Reception Comp etc.) |
|
New Computer I.D: |
(if available) |
New Computer Description:*
(eg. Reception Comp etc.) |
|
Reason for change:* |
|
| |
|
I agree to the termination of the old licence which was issued for the previous computer indicated above. |
I agree to accept
to the above terms*
|
| |
|
(NOTE: fields marked with an * are required)
|
