WIZMANAGER ORDER FORM Please send your check or money order to: **************************************** Mijenix 6666 Odana Road, Ste 326 Madison, WI 53719 Tel&Fax: (608)277-1971 CompuServe: 75430,1545 Please place credit card orders through: **************************************** Public Software Library (PsL) P. O. Box 35705, Houston, TX 77235-5705 USA Sales: 1-800-242-4775 Overseas : (713) 524-6394 Fax : (713) 524-6398 CompuServe: 71355,470 ****************************************************************** THE PsL NUMBERS ABOVE ARE EXCLUSIVELY FOR PLACING ORDERS WITH CREDIT CARDS, MIJENIX CANNOT BE REACHED AT THOSE NUMBERS. IF YOU HAVE QUESTIONS ABOUT THE STATUS OF YOUR ORDER, VOLUME DISCOUNTS, WIZMANAGER, ETC, PLEASE CONTACT MIJENIX DIRECTLY. ****************************************************************** NAME: _________________________________________________________ COMPANY: _________________________________________________________ STREET: _________________________________________________________ CITY: _____________________________ STATE: _____ ZIP: _________ COUNTRY: _______________________ TEL: _____________ FAX: _________ WizManager (item #10869) $ 39.95 US x ___ unit(s) = $ _________ Shipping & Handling: Continental U.S. $ 4.00 AK, HI, Canada, Mexico $ 6.00 International $ 12.00 Express USA $ 20.00 > $ _________ < Subtotal: > $ _________ < Wisconsin residents add 5.5% sales tax: > $ _________ < TOTAL: > $ _________ < Diskette format: __ 5.25" or __ 3.5" Payment by: __ Mastercard __ Visa __ AMEX __ Discovery __ Check (US) __ Certified Check (US) __ Money Order Card #: _________________________________________ Exp. Date: ____ Card Holder Name: _______________________________________________ Signature: ______________________________________________________