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  1.     ---------------------------------------------------------------------
  2.  
  3.                            Order Form - CDB For Windows
  4.  
  5.  
  6.      
  7.     Name:              _________________________________________________
  8.  
  9.     Company:           _________________________________________________
  10.  
  11.     Address:           _________________________________________________
  12.  
  13.     City, State, Zip:  _________________________________________________
  14.  
  15.     Telephone:         _________________________________________________
  16.  
  17.     Country:           _________________________________________________
  18.  
  19.     E-Mail Address:    _________________________________________________
  20.  
  21.  
  22.     Disk Media:
  23.  
  24.     5 1/4 " diskette   ___
  25.  
  26.     3 1/2 " diskette   ___
  27.  
  28.  
  29.     Number of Copies   ___  X  $149  = ______________
  30.  
  31.  
  32.     * New Jersey residents please add %7 sales tax.
  33.     * All checks or money orders must be payable in US Dollars.
  34.      
  35.  
  36.     COMMENTS: Please feel free to add your thoughts or suggestions!
  37.  
  38.     _____________________________________________________________________
  39.  
  40.     _____________________________________________________________________
  41.  
  42.     _____________________________________________________________________
  43.  
  44.     _____________________________________________________________________
  45.  
  46.     _____________________________________________________________________
  47.  
  48.      
  49.     Make Checks payable to:     Daytris
  50.  
  51.     Mail to:                    Daytris
  52.                                 81 Bright Street, Suite 1E
  53.                                 Jersey City, NJ  07302
  54.                                 201-200-0018
  55.  
  56.