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                      KwikDraw Order Form

                      The Human Interface
                      902 94th St. S.E.
                      Everett, WA  98208

                      (206) 348-9043
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Name:    ________________________________________________________

Address: ________________________________________________________

City:    _______________________ State: _______ Zip: ____________



Qty: _______ x $31.95  = $______________      Shipping Rates:
                                              
Shipping (see rates)   = $______________      Qty 1-3:   $3.00
                                              Qty 4-6:   $5.00
Total                  = $______________      Qty 7-10:  $7.00


please check one:

________  Please ship C.O.D. (U.S. only, $3.00 additional charge)

________  Check enclosed

________  Mastercard No. ________________________________________

________  Visa No. ______________________________________________


please allow 3 weeks for delivery