Name And Surname*


Address Sreet*


Suburb*


City*


Code


Contact Number*


Email address*



PLEASE COMPLETE ALL FIELDS BELOW

How did you hear about fishX: Facebook fishX Website A Friend Other

Choose an edition:* Pro Edition Lite Edition

Choose your fishX system version:* 32 bit system 64 bit system
(NB: You can check the system version at the top of the evaluation screen on the fishX software.)

Choose number of users:* PRO EDITION: 1 user @ R300 per unit PRO EDITION: 2 users @ R330 per unit LITE EDITION: 1 user @ R240 per unit LITE EDITION: 2 users @ R270 per unit


SOFTWARE USERS (This section must be completed)
FIRST fISHX USER DETAILS
Name And Surname*


Gender:* Male Female

Group:* Junior Senior Veteran

Date Of Birth*


SECOND fISHX USER DETAILS
Complete this section only if you selected 2 users for your software.
Name And Surname*


Gender:* Male Female

Group:* Junior Senior Veteran

Date Of Birth*



By completing this form you agree that all the information supplied are correct and true.

Signed At (City):*


Date*


NAME AND SURNAME*