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Product Order Form

From: 
                                                                                                                                    
Date:

________________________________________                                                _____________________

________________________________________

________________________________________

To: 

True BASIC Inc.
12 Commerce Avenue, Suite 3, West Lebanon NH 03784-1669
24-Hr. Fax: 603 298-7015   •  800 436-2111  •  e-mail: sales@truebasic.com

Order:

____
 QwikRAFFLE™ for Macintosh.   
Item #: 79-008&Q.
    @ 29.00 each :          _______

____
 #76-011 Perfed paper for raffle tickets.  100-sheet pack
  @ 6.00 each :     _______

____
 #76-012 Perfed paper for raffle tickets.  500-sheet pack
  @ 24.00 each :  _______

____
 QwikBILL™ for Macintosh.   
Item #: 79-001&Q.
    @ 49.00 each :                   
_______

____
 QwikBILLTIME™ for Macintosh.   
Item #: 79-033&Q.
 @ 29.00 each :           
_______

____
 QwikMAILIST™ for Macintosh.   
Item #: 79-020&Q.
    @ 19.00 each :           
_______

____
 #76-3x10 Labels.   50-sheet pack (1500 labels).
    @ 8.95 each :                    _______

____
 #76-3x10 Labels.   250-sheet pack (7500 labels).
    @ 35.95 each :              _______

____
 #76-2x5 Labels.   50-sheet pack (1500 labels).
    @ 8.95 each :                      
_______

____
 #76-2x5 Labels.   250-sheet pack (7500 labels).
    @ 35.95 each :                
_______

____
 ZipZAPP™ for Macintosh.   
Item #: 53-MAC&Q.
    @ 29.00 each :                 
_______

____
 QwikCONGRESS™ for Macintosh.   
Item #: 79-015&Q.@ 19.00 each :     
_______

                                                                                                                                                       Shipping:
           $5.00

                                                                                                                                     Total Enclosed:
   $   _______

Payment by: 

 [   ] Cash, check or money order;    [   ] Visa;    [   ] MasterCard;   [   ] Discover;   [   ] AMEX

Credit Card Number: ________  ________  ________  ________    
Expiration Date: ______

Signature: ____________________________