Warranty Card v2.01
		   Registration Form/Invoice.

Please complete this order form and mail to:

			Genesis PC-Ware
		  	  P.O. Box 86
	      	      Mankato, MN   56002

			<or>

	E-Mail:	jholt@prairie.lakes.com

Check form of payment:
	
	Check: ___    Visa: ___    Mastercard: ___

Credit card orders:

	Card Number: _______ - _______ - _______ - _______
	
	Card Expiration Date: ____/____

        Signature: _______________________________________

Warranty Card v2.01:quantity _____ @ $20.00 ea. = _____________

Minnesota residents add 6.25% sales tax         + _____________

                                  Total payment   _____________

Payments must be in US dollars drawn on a US bank.

            Name: ______________________________ Date: _________

         Company: ______________________________________________

         Address: ______________________________________________

                  ______________________________________________

City, State, Zip: ____________________________ Country: ________

       Day Phone: ________________ Evening Phone: ______________

E-Mail address: _______________________________________

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