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|       Register: FaxMail for Windows, FAXWIN34.ZIP, 1-713-261-0307        |
|   ElectraSoft, 3207 Carmel Valley Drive, MISSOURI CITY, TX  77459-3068   |
|==== Please Print ========================================================|
|                                                                          |
| Date___/___/___ Country__________________ Wk Phone______________________ |
|                                                                          |
| Name_____________________________________ Hm Phone______________________ |
|                                                                          |
| Address__________________________________ Fx Phone______________________ |
|                                                                _         |
| City_________________________________ State_____ ZIP____________________ |
|==========================================================================|
| Disk Size:  __3.5-1.4MB  __5.25-1.2MB  __Other__________________________ |
|-----+--------------------------------------------------------------------|
| Qty | Item                                                     Amount    |
|-----+--------------------------------------------------------------------|
|     |                                                                    |
|     | FaxMail for Windows - - - - - - - - - - - - - - - $25.00 $_____.__ |
|-----|                                                                    |
|     | OCR, Optical Character Recognition, Fax-to-text - $15.00 $_____.__ |
|-----|                                                                    |
|     | Zoom/Edit Fax, Zoom in and edit a Fax - - - - - - $15.00 $_____.__ |
|-----|                                                                    |
|     | DCX to PCX Breakup, Convert Fax to .PCX file(s) - $15.00 $_____.__ |
|-----+----------------------- or -------------------------------          |
|     | All of the above ($15.00 savings) - - - - - - - - $55.00 $_____.__ |
|-----+------------------------------------------------------------------- |
|                                                                          |
| Total Price of Merchandise  - - - - - - - - - - - - - - - - -  $_____.__ |
|                                                                          |
| Texas residents, please, add Sales Tax (8.25%)  - - - - - - -  $_____.__ |
|                                                                          |
| Registration, Shipping, and handling  - - - - - - - - -  $4.00 $____4.00 |
|                                                                          |
| Total (Pay this amount) - - - - - - - - - - - - - - - - - -  US$_____.__ |
|--------------------------------------------------------------------------|
| __Cash       __Check      __DISCOVER   __VISA       __MC         __AmEx  |
|                                                                          |
| Card Number_____________________________________________ Exp Date___/___ |
|                                                                          |
| Print name as it appears on card________________________________________ |
|                                                                          |
| Signature_________________________________________ Date Today___/___/___ |
| (or Name if sending FidoNet, Internet or FAXing with computer)           |
|==========================================================================|
| Order Methods:                                                           |
| Phone: Call ElectraSoft at 1-713-261-0307                                |
| or fill out this form and Send it to...                                  |
| Mail: ElectraSoft, 3207 Carmel Valley Dr, MISSOURI CITY, TX  77459-3068  |
| FAX: 1-713-499-5939,11,11,11,11  (where , is a pause and 11 is a router) |
| BBS: 1-713-499-5939                                                      |
| Internet: Jon.Krahmer@f10000.n106.z1.fidonet.org                         |
| Internet: JonK@blkbox.com                                                |
| FidoNet: Jon Krahmer on 1:106/10000                                      |
|                                                                          |
| Where did you here about FaxMail for Windows____________________________ |
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| Optional; to help us better serve you:                                   |
| Which Fax/Modem-Driver works best (found in your AUTOEXEC.BAT):          |
| __FM_ROCK2.COM     __FM_ROCK1.COM     __FM_ATT1I.COM     __FM_ATT2I.COM  |
| __FM_PP1.COM       __FM_CLS2I.COM     __FM_CLS2E.COM     __FM_DOVE1.COM  |
| __FM_DALAS.COM     __FM_ZOOM2.COM     __FM_ZYXEL.COM     __FM_CLAS1.COM  |
| __FM_WN_FD.EXE,  Fax/Modem Brand/Mod#___________________________________ |
| Data Speed: __1200bps __2400bps __9600bps __14400bps __Other____________ |
| FAX Speed:  __1200bps __2400bps __9600bps __14400bps __Other____________ |
| Supported: __HST __V.32 __V.32bis __V.42bis __Other_____________________ |
| Computer Brand__________________________________________________________ |
| Processor: __8088 __80286 __80386 __80486 __Other_______________________ |
| Machine Speed: __25Mhz __33Mhz __50Mhz __66Mhz __Other__________________ |
| Display Type: __CGA __EGA __VGA __SVGA __Other__________________________ |
| Floppy Drive(s): __3.5, 1.4MB __5.25 1.2MB __Other______________________ |
| HardDrive Brand/Mod#_________________________________ size____________MB |
| Bugs or suggested improvements _________________________________________ |
| ________________________________________________________________________ |
| ________________________________________________________________________ |
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