Authorization Form

use this form to authorize particleillusion 3.0 by email or fax. authorize via internet at:

http://authorize.wondertouch.com

**** all fields are required ***** first name: _____________________________ last name: ______________________________ company name (if applicable): ___________________________________ address: ________________________________________ ________________________________________ state/province:

________________________________

country: ___________________________ zip / postal code: _________________ phone: _____________________________ email address: _______________________________________ (please verify that your email address is correct, as authorization codes will be sent via email.) enter the following codes exactly as they appear in the particleillusion 3.0 authorization dialog. you should use copy and paste if possible. mid: ____________________________________ site code: ____________________________________ email this completed form to:

[email protected]

or fax to: 1-630-477-0349 you should receive your authorization code via emial within 48 hours. ******* this information will be kept strictly confidential.

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