JUST ASK PURCHASING
                            1001 S. 10th Drive
                            Show Low, AZ 85901
                            602-537-5542
                              
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                      PLEASE PROVIDE ALL INFORMATION
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TYPE OF COMPUTER: 520ST    1040ST   SINGLE SIDED  DOUBLE SIDED
                  
                  EXPANDED MEMORY   HOW MUCH?


NAME:____________________________________________________________

ADDRESS:_________________________________________________________

CITY:_____________________________STATE:____________ZIP:_________

PHONE: (     )_________________________________________

METHOD OF PAYMENT:

 CHECK ( )  MONEY ORDER ( ) VISA ( )  MASTERCARD ( )

 CHARGE CARDS $20.00 MINIMUM

ACCOUNT NUMBER_________________________________________________

EXPIRATION DATE________________________________________________

SIGNATURE______________________________________________________

                 ( CHECKS SUBJECT TO BANK CLEARANCE )


  
QUANTITY ORDERED*****DISK # ******DESCRIPTION****UNIT PRICE**TOTAL

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                                                  SUB TOTAL_______
                               ARIZONA RESIDENTS ADD 7% TAX_______
                               SHIPPING AND HANDLING CHARGE_______
                                                      TOTAL_______

              SHIPPING CHARGES: 5 DISKS OR OVER NO SHIPPING
                              UNDER 5 DISKS $1.25 PER ORDER