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  1.                                 ORDER FORM
  2.  
  3. Date:________________                
  4.  
  5. This order form may be used to order single copies of any Micro System
  6. Solutions product.  To order multiple copies of the same product requires a
  7. licensing agreement. Call Micro System Solutions at (303) 795-7653 for
  8. multiple copy discount prices.  See licensing information on next page.
  9.  
  10. FROM:
  11. Name:____________________________   Company:_________________________
  12.  
  13. Address:_________________________   Title:___________________________
  14.  
  15. City:______________________ State:________ Zip:___________
  16.  
  17. Telephone:_____________________ Home( )  Office ( )
  18.  
  19. Where did you first hear about this product   _______________________
  20. ***************************************************************************
  21. ***************************************************************************
  22.             PRODUCT                             PRICE       
  23.  
  24. Personal Asset Register (PAR)                   $37.00       _______
  25.      Version 1.1
  26.  
  27. The costs below are for a single product.
  28.  
  29.           Shipping and Handling                 $ 3.50     + _______
  30.  
  31.           For 3.5" diskettes add:               $ 1.00     + _______
  32.  
  33.           For overseas shipment add:            $ 1.50     + _______
  34.  
  35.                                     Order Subtotal:        $________
  36.  
  37.                  Colorado customers add 3% state sales
  38.                  tax and appropriate local tax:            + _______
  39.  
  40.                  Customers paying by check deduct
  41.                  3% cash discount based on subtotal        - _______
  42.  
  43.                                     Order Total:           $________
  44.  
  45. Diskette format   5.25"______ or 3.5"_______ (check one)
  46.  
  47. Send to:                               
  48.    **************************     VISA or MASTERCARD ACCEPTED:
  49.    * Micro System Solutions *          (circle one)
  50.    * 5417 S. Cimarron Rd.   *     Card No.___________________________
  51.    * Littleton, CO  80123   *     Expiration Date:____/____
  52.    **************************
  53.                            Signature:________________________________
  54.                                      (As Name Appears on Card)
  55.  
  56.