VISUALIB Registration Form
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Visual Tech
P.O. Box  8735
Fort Wayne, IN 46898-8735
(219)489-0235    FAX: (816)746-6618
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Product                 Quantity        Unit Price      Amount		

Visualib v2.5 DLL       ______          $399.00		$ ______
(Windows all compilers)

Visualib source code    ______          $300.00		$ ______
(v1.02 all compilers)

Visualib for Windows    ______          $50.00		$ ______
(v1.02 Microsoft C/C++)

Visualib for Windows	______          $50.00          $ ______
(v1.02 Borland C/C++)

Visualib for DOS        ______          $40.00          $ ______
(v1.02 Microsoft C/C++)

Visualib for DOS        ______          $40.00          $ ______
(v1.02 Borland C/C++) 				

                                               Subtotal $ ______


             Indiana Residents must add 5.0 % sales tax $ ______


                                               Shipping $ 15.00


                                                  TOTAL $ ______

Disk Format :  [ ]5.25"    [ ]3.5"

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Address : _______________________________________________________

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