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  1. ------------------------------[ ORDER FORM ]---------------------------------
  2. Pow Productions
  3. Attn: Steve Wolfe                  Contact us on the Internet:
  4. 1965 West 4055 South               http://kublai.pacificrim.net/~solaris
  5. West Valley City, UT 84119         conan@enterprise.net
  6. U.S.A.
  7. -----------------------------------------------------------------------------
  8.  
  9.                     Prices are in AMERICAN DOLLARS.
  10.           This order form is for orders in the USA and Canada.
  11.  
  12.   Please check the appropriate [ ] boxes below and add up the totals.
  13.  
  14. [ ] Powball (3.5" High Density disks only).................(@ $12) __________
  15.  
  16.                              USA/Canada Shipping & Handling (@ $3) 
  17.                                       (International add $2 extra) __________
  18.  
  19.                                  Utah residents must add 6.25% tax __________
  20.  
  21.                                                     Total enclosed __________
  22.  
  23.  
  24.         Name: _______________________________________________________________
  25.  
  26.      Address: _______________________________________________________________
  27.  
  28. City, ST Zip: _______________________________________________________________
  29.  
  30.      Country: ____________________  Phone: __________________________________
  31.  
  32. Please make your [ ] Check or [ ] Money Order payable to Mr. Steve Wolfe
  33.