+------------- HQ-FAX / FAXHAVEN Shareware Registration & Order Form ----------+
|                                                                              |
| FROM: _______                                 TO:                            |
| Name .......~______________________________ |                               ~|
| Company ....~______________________________ | HTF Consulting                ~|
| Address 1 ..~______________________________ | 436 Whitehall Rd. Suite #F    ~|
| Address 2 ..~______________________________ |                               ~|
| City St Zip ~______________________________ | Alameda, CA. 94501            ~|
| Voice number~____________________           | (510) 521-1689                ~|
| FAX number .~____________________           | (703) 937-3630                ~|
|                                                                              |
| FAX Registration to:  _ __(800)483-6737  or _ _____(703)937-3630             |
|                                                                              |
| PRODUCT: HQ-FAX ($29.00) _  FAXHAVEN ($39.00) _  HQFAXBAK ($29.00) _         |
| ADD'L FONTS: Standard add-on pack (TRomono,Swizmon,Procoor $25.00) _         |
| Choose any 3 ($30.00) TRomono _  Swizmon _  Procoor _  Prestij _  Presmon _  |
| Diskette size:3.5" _  5.25" _                                                |
|                                                                              |
| PAYMENT METHOD: VISA Acct. # ____ ____ ____ ______  Exp date __/__           |
|                 Checking Acct. # _____________      Check # __________       |
|                 Bank name ____________________________________________       |
|                                                                              |
| Where did you find HQ-FAX/FAXHAVEN? ________________________________________ |
+--------------- F1 = Help, F2 = Verify, F8 = GO, <ESC> = Exit ----------------+
|                 Line 25 is a status line for error messages                  |