Initial Registration Form

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Warning icon Note to Resellers:

Resellers must not submit this form on behalf of their customers!

Warning icon Note to Customers:

By submitting this form you will enter into the legal agreement in between you (the "Licensee") and Captcha, Inc (the "Vendor") and accept to be bound by the latest version of the BotDetect CAPTCHA Subscription-License Agreement (the "Agreement")!

Warning icon Note to Spammers, Spam-tool Vendors, Other Miscreants, and Their Fronts:

The Agreement contains clauses specifically designed to ensure that you neither ever receive executables / source-code, nor to ever be issued a refund; and to waste you the maximum amount of time and financial resources in an intentionally never-ending process; all while the Vendor collects the data that will be passed to the relevant law enforcement agencies!

Please note that, as a part of our customer identification process, all of the submitted data will be verified before the delivery takes place!

1. ORDER INFO

Order Reference Number
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2. REQUESTED RELEASE

 

3. BOTDETECT USE INFO

URLs that allow us to understand where BotDetect will be used

4. LICENSEE INFO

Licensee Organization's Name, Website, and Address

5. CONTACT INFO

Licensee's Technical Contact
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Licensee's Billing Contact
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Licensee's Legal/Administrative Contact
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6. ADDITIONAL COMMENTS

Whatever Additional Info or Comments You Might Wish to Share:

7. LICENSE AGREEMENT

BotDetect License:
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IP Address:

Country:

GMT Datetime:

Local Time:

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Browser / Version:

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