CREDIT CARD ORDER FORM - USE THIS FORM TO REGISTER BY CREDIT CARD

Credit Card orders are taken by PsL (Public Software Library).
PsL takes the orders and passes your name and address on to me.
I process your orders and send out the registration package. If
you have any questions or problems please contact ME. See the 
on-line help or About box for information on how to contact me.
PsL is not responsible for support and does not have any
technical information about this program.

Complete and send this form to PsL at:

E-mail        : 11953@pslweb.com
Fax           : 1-713-524-6398
Phone (voice) : 1-800-242-4PSL (7am-6pm CST)
              : 1-713-524-6394

If you order by phone be sure to mention the Product ID below.
_________________________________________________________________
Program    : My Personal Diary for Windows
Version    : 4.55C
Product ID : 11953

LATEST VERSION AVAILABLE ON OUR WEB PAGE.  ALL DOCUMENTATION IN
ELECTRONIC FORM.  REGISTRATION CODE SENT WITHIN 2 BUSINESS DAYS.

Please register me for _1_ copies @ $24.95 each = $ 24.95

                PsL FEE                   --->  + $  5.00
                          
                CHARGE THIS AMOUNT        --->    $ 29.95

                __ Send my registration code by e-mail
                __ Send my registration code by regular mail

Name       : 

Address    : 


Phone/Email: 

Card Type  :    [ ] VISA  [ ] MASTERCARD  [ ] DISCOVER  [ ] AMEX

Card #     : 
Exp. Date  :

Signature  __________________________________________

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PLEASE DOUBLE CHECK YOUR CREDIT CARD INFORMATION BEFORE SENDING.
MAKE SURE THE NAME IS THE SAME AS THE NAME ON THE CREDIT CARD.