Order Form


    Name     ____________________

    Address  ____________________    Apartment #  ______

    City     ____________________    State        ______   Zip  __________

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    QUANTITY  |                PRODUCT                     |  PRICE  |  TOTAL
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              |  Software: The X-Zone:  A Math Odessey     | $       |
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              |  Curriculum Guide: Pre-Algebra Concepts    |         |
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                                      In Florida, add 6.5% sales tax |
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                 TOTAL                                     |         |
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    [ ]  5.25" disk (high density) requested.
    [ ]  I would like information about your gift wrap/shipping service

    Make check payable to:

    B & W Software
    P.O. Box 128
    Thonotosassa, FL 33592

    Shipping address if different from above:

    Name     ____________________

    Address  ____________________    Apartment #  ______

    City     ____________________    State        ______   Zip  __________

    Country  ____________________