Software USA                                                      Shareware Library Order Form
(To print this form, select print under the file menu)
																																							Shipping and Billing Information
Please Print
Name:                                                                                                             

Address:                                                                                                          

City/Town:                                                                                                                                          

State/Province:                                 Postal/Zip Code:                                                                  

Phone:(          )                -                        Country:                             Member#:                           
Payment Methods (Credit Card ONLY)
[   ]MasterCard  [   ]Visa  [   ]American Express  [   ]Discover
Credit Card Number:                                     Expiration date:              /              /              
Signiture:                                                         

Mail completed forn to:                                  Software USA
                                                                           Attn: Shareware Archives
                                                                           9565 Waples St.
                                                                           San Diego, Ca 92121
Shareware Titles ordered
Fees: $3.00 (US) per program/minimum order of 5 programs
Part Number- Program Name
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Subtotal $      
Sales Tax $    (7.75% - CA residents only)
Shipping $       (Charges $4.95(US) / $7.75 (International))Total $