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  2. Dial 800-242-4775 for credit card ORDERS ONLY!  Or print and mail in this form.
  3. (To expedite your order, tell the operator you are purchasing product #10827.)
  4. Other ORDER ONLY #s: Overseas 713-524-6394 : FAX 713-524-6398 : CIS 71355,470.
  5. DO NOT dial the above numbers for information!  For INFO dial 606-263-2687.
  6.  
  7.             Your Name: ______________________________________________
  8.  
  9.  Your Mailing Address: ______________________________________________
  10.  
  11.                        ______________________________________________
  12.  
  13.                        ______________________________________________
  14.      Floppy Disk Size: ( )3.5" High Density    ( )3.5" Low Density
  15.                        ( )5.25" High Density   ( )5.25" Low Density
  16.  
  17.      Number of Copies: _______  ┌──────────────────────────────────────────┐
  18.                                 │ Prices: 1 Copy-$35, 2-5 Copies-$30 each  │
  19.                                 │         6-10 Copies-$28 each, 11 or more │
  20.                                 │         copies $27 each.                 │
  21. Total Amount Enclosed: $______  └──────────────────────────────────────────┘
  22.                                                        (Program Version 1.2)
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  24.       Make your check or money order payable to: Russell Holloway.
  25.  
  26.                          The mailing address is: Russell Holloway
  27.                                                  305 Lindenhurst Drive
  28.                                                  Suite 1138
  29.                                                  Lexington, KY  40509
  30.