Tablica/2 1.2 order form
-------------------------

Please fill out the following information:

First Name:_______________________

 Last Name:_______________________
 
   Address:_________________________________
   
           _________________________________
           
           _________________________________
           

                                 Optional:

                                 E-mail:___________________________________

                                    Fax:___________________________________
   
                                  Phone:___________________________________
           



License:     [ ] single user (15 USD)

             [ ] site        (25 USD)


Disk type:   [ ] 3.5"        (add 2 USD)

             [ ] None, please send me only the registration number


Total $$$ enclosed: ______________             


Comments:  _____________________________________________________________

           _____________________________________________________________
           
           _____________________________________________________________
           


Attach check/cash/M.O. and mail it to:

PETER RACHWAL
1525 NE 7 ST
GAINESVILLE, FL 32601
USA

                              **** THANK YOU *****