Product Registration:  (MAR492-1, Wonders of Science)

Return this form to receive upgrades, discounts and new product information. Mail to: Arc Media Inc., 5330 Main Street #210, Buffalo, NY 14221-5360, fax to:  (416) 410-9651 or web site: www.arcmedia.com

Name: ______________________________________________________________

Age: ______________ Occupation: _______________________________________

Street: _____________________________________________________________

City: ___________________________________ State: ______________________

Country: ________________________ Zip/Postal Code: ______________________

Telephone: ___________________________ Fax: ___________________________

E-mail: _____________________________________________________________

Computer Type:    [  ] Macintosh    [  ] Windows 95    [  ] Windows 98    [  ] Windows NT

Please rate this product:    [  ] Excellent    [  ] Good    [  ] Poor

Comments: __________________________________________________________

ORDER FORM

Title Name                                                                                  Part #                Qty

1 ______________________________________________    ___________    ___

2 ______________________________________________    ___________    ___

3 ______________________________________________    ___________    ___

Order paid by:    [  ] Check   [  ] Money order    [  ] MasterCard    [  ] Visa    [  ] Amex

    Credit Card #: ____________________ Name: ____________________________  

    Expiry date: ___________________ Signature: ___________________________

Please make check or money order payable to ARC MEDIA INC.
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