**************************************************************************** ** ** ** ------------------------------------------------ ** ** SRC Enterprises Slider Custom Control Order Form ** ** ------------------------------------------------ ** ** ** ** Send order to: ** ** ** ** Steven R Clabaugh ** ** 550 N. Pantano Rd. #286 ** ** Tucson, Arizona 85710 ** ** ** **************************************************************************** Name (Please Print) ________________________________________________________ Address ____________________________________________________________________ City _______________________________________________________________________ State ___________________________________ ZIP Code _________________________ Phone/Fax __________________________________________________________________ Payment Method: Check [ ] Money Order [ ] Bank Cashiers Check [ ] Payable to: Steven R Clabaugh Number of Copies _______________________ ( $15.00 per copy ) $ ____________ Shipping and Handling ( $5.00 per order ) $ ____________ Total Amount Enclosed: $ ____________ All orders will be shipped on 3.5" HD diskette to the above address unless otherwise specified. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ And if you have the time, where did you get the shareware version from? ____________________________________________________________________________ ____________________________________________________________________________ Your order is greatly appreciated!! Steven Clabaugh