InfoMiles v1.3 Order Form
                
  Mail Orders To  (See ReadMe.Txt for further information.)

    BMT Micro              or   BMT Micro 
    PO Box 15016                452 Horn Road 
    Wilmington, NC 28408        Wilmington, NC  28412-2411 
    U.S.A.                      U.S.A. 

  Mail sent to the post office box arrives first and is processed first.
  You can often cut a day off your order arrival time by using the PO box. 
 
  We accept Visa, Mastercard, Discover, American Express, EuroCard, 
  Optima, Money Order, Cashiers Check, Personal Check.  Please do not 
  send cash in the mail.  Personal checks are subject to clearance. 
 
  Name ________________________________________________________________ 
 
  Company _____________________________________________________________ 
 
  Address _____________________________________________________________ 
 
  Address _____________________________________________________________ 
 
  Phone _______________________________________________________________ 
 
  Fax _________________________________________________________________
 
  Email Address _______________________________________________________ 
 

  Product                    Quantity        Price 
  _________________________  ___________     ____________ 
 
  InfoMiles v1.3             ___________   x $34.95 (US)  = + $ _______ 
 
  Shipping and Handling                                     + $ _______ 
      Free - 1st Class
    $ 7.00 - Airborne (Next day most places, USA Only)
    $12.00 - Airborne (Alaska and Hawaii)
    $13.00 - Federal Express (USA Only)
    $25.00 - Federal Express (Canada/Mexico)
    $30.00 - Federal Express (Europe/Japan)
    $16.00 - Express mail (Outside USA)

  Total                                                       $ _______ 
  
   For credit card payment only 
 
   Circle one  VISA / Mastercard / Discover / American Express / Optima 
 
   Credit card number  ________________________________________________
 
   Expiration date  ___________________________________________________
 
   Authorization signature   __________________________________________