------------------------------------------------------------------------- | Pik A Program Order Form | ------------------------------------------------------------------------- THANK YOU FOR REGISTERING YOUR SHAREWARE! Important: If you are ordering by mail, e-mail, or fax, please completely fill out this form and send it in. Please write legibly, and if you fax your order in, please use black ink for a clear transmission. If you are sending a check or money order, please make sure that payment is made in US funds drawn on a US bank. Technical support is not available from Pik A Program. For any technical help, please contact Windowshare directly online: CompuServe: GO WSHARE Internet: You may mail, fax, e-mail, or phone in your order. Please send the completed registration form, along with payment to Pik A Program, Inc. at: ------------------------------------------------------------------------- | Pik A Program ORDER FORM | ------------------------------------------------------------------------- Pik A Program (tm) TOLL FREE (ORDERS ONLY) 1-800-TOREGISTER 13 Saint Marks Place (867-3447) NY, NY 10003 Telephone (212) 598-4939 USA Fax (212) 228-5879 Compuserve: 74777,3233 Internet: 74777.3233@compuserve.com __________________________________________________________________________ (Name) __________________________________________________________________________ (Company) __________________________________________________________________________ (Street1) __________________________________________________________________________ (Street2) __________________________________________________________________________ (Town) (State) (Zip) __________________________________________________________________________ (Telephone) (Fax) (Country if outside USA) __________________________________________________________________________ (e-mail) Shipping is optional. If you would like to receive a diskette with the program, just say so, and add $4.00 to your order to cover shipping. If you only want the code to unlock the program e-mailed to you, don't add the shipping, but be sure to include your e-mail address. QUANTITY ITEM PRICE EACH TOTAL -------------------------------------------------------------------------- W3rite For Windows US $49.95 US$ -------------------------------------------------------------------------- Shipping (optional) US $ 4.00 US$ -------------------------------------------------------------------------- TAX (NYS residents only) ___ % US$ -------------------------------------------------------------------------- TOTAL: US$ ================ Shipped orders are sent on 3.5" diskettes unless otherwise requested. Prices are good through 12/96, subject to change thereafter. I am paying by: ( ) CHECK ( ) VISACARD ( ) MASTERCARD ( ) AMERICAN EXPRESS ( ) CASH (by registered mail only, please) ( ) DISCOVER CARD Number ______-______-______-______ Exp. date ___-___ We would appreciate it if you would tell us where did you first heard about this program. Thanks for your cooperation. [] BBS/Online service - which one?______________________________________ [] Friend [] retail store package [] CD-ROM ______________________ [] magazine - which one?_________________________________ [] other - ______________________________________________