AmiStation ORDER FORM    Prices subject to change without notice.


    TO:                                   Date: ____________________
                Duane K. Fields
                PO Box 1315
                College Station, TX 77841
                USA
    FROM:
          Name: ____________________________________________________

     [Company]: ____________________________________________________

       [Title]: ____________________________________________________

       Address: ____________________________________________________

          City: ____________________________________________________

         State: ___________________________ Zip Code: ______________

       Country: ___________________________ Phone: _________________

        E-Mail: ____________________________________________________

 
    ========================================================================

    Backdoor password: __________________________ (16 characters max)
  
    Write this down!  If you forget your password, you will have to mail
    me a SASE requesting me to look it up.  If you wish to change this
    password in the future you will have to get a new copy.  Same
    replacement cost as obtaining a program update.
    
    ========================================================================

            Registration fee for AmiStation is $10.00 (ten dollars)
            Overseas users should include an extra $3 to cover expenses

    ========================================================================


                                                     TOTAL ENCLOSED ______

    Payment method: ( ) Check ( ) Cash ( ) Money order


   ========================================================================

    AUTHORIZED SIGNATURE:__________________________________________________

    TITLE: __________________________________________ DATE:________________


   ========================================================================

    TERMS:

    Check, US POSTAL Money Order or Money Order drawn on a USA bank in USA
    funds made out to Duane K. Fields.  All orders outside of North
    America should include an extra $3 cover my mailing costs.  Please
    allow a couple of weeks for delivery.

   ========================================================================

    1) How did you find out about AmiStation

        ( ) Friend            ( ) BBS          ( ) Usenet News

        ( ) Other ________________________________________________________


    2) What do you especially like about AmiStation (as many as apply)

        ( ) Nifty login panel ( ) Usage log
        ( ) Pricing           ( ) Backdoor feature
        ( ) Support           ( ) Finger utility
        ( ) Documentation     ( ) User editing

        ( ) Other ________________________________________________________


    3) What do you especially dislike about AmiStation? (as many as apply)

        ( ) Nify login panel  ( ) Usage log          ( ) Interlaced login
        ( ) Pricing           ( ) Backdoor feature
        ( ) Support           ( ) Finger utility
        ( ) Documentation     ( ) User editing

        ( ) Other ________________________________________________________


     4) What other features would you like to see in AmiStation?
 
        __________________________________________________________________

        __________________________________________________________________

        __________________________________________________________________

        __________________________________________________________________


     5) What problems have you found with AmiStation?
	
        __________________________________________________________________

        __________________________________________________________________

        __________________________________________________________________

        __________________________________________________________________