QuikCal Order Form:

Make check or money order payable to:

								Alan Johnson
								124 Haywood Drive
								E. Brookfield, MA 01515
								(508) 867-9834
								CompuServe: 76120,556


Name:            ________________________________________
Address:         ________________________________________
Address:         ________________________________________
City, ST, Zip:   ________________________________________

Quantity of QuikCal @ $9.95 (US) each: ____        Dollar Total: __________
If Massachusetts residence, 5% Sales Tax:                        __________
TOTAL AMOUNT ENCLOSED:                                           __________


We thank you for your order!

I prefer:
___ 5 1/4" diskette
___ 3 1/2" diskette

I received QuikCal from:
___ Shareware Vendor
___ CompuServe
___ Genie
___ Other On-line or Bulletin Board service: ___________________