Please fill out, print, and mail this form to:

********************************
*  Carlos Moya                 *
*  RE: Simona Planner          *
*  535 West 51 Street #5G      *
*  New York, NY 10019          *
********************************

Along with a check or money order for 
$25.00 (US Dollars)

		Simona Planner Order Form
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First Name:
Last Name:

Address:
Address:
City:
State:
Country:
Zip Code:

Day Telephone:
Evening Telephone:
E-Mail:

Preferred method of delivery (circle one): E-Mail or Regular Mail

Comments:


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NOTE: If you choose to receive the registered version of Simona
Planner via E-Mail and there have not been any major revisions to
the program you may opt to receive a "Registration Key" which is
a small file that when placed into the same folder on your hard
drive as Simona Planner will automatically upgrade Simona Planner
to registered status.