REGISTRATION/ORDER FORM               IW20

To: ARK ANGLES        Phone: (047)588100 or Intl+61-47-588100
    P O Box 190       Fax:   (047)588638 or Intl+61-47-588638
    Hazelbrook 2779   Internet:     100237.141@compuserve.com
    AUSTRALIA         CompuServe:                  100237,141

Name    _____________________________________________________

Company _____________________________________________________

Address _____________________________________________________

Town    ________________________  State _______  Code _______

Country _____________________________________________________

Phone   ___________________________  Fax ____________________

E-mail  _____________________________________________________

Where software seen or obtained _____________________________
Computer:  [ ] XT   [ ] AT/286   [ ] 386   [ ] 486   [ ] >486
Memory Size: ____________    Hard Disk Size: __________
Drives: [ ] 5.25 360K [ ] 3.5 720K [ ] 5.25 1.2M [ ] 3.5 1.4M
Screen: [ ] Mono/Herc  [ ] CGA   [ ] EGA   [ ] VGA   [ ] >VGA
Dos Ver# ________   Windows Ver# ________   OS/2 Ver# _______
 _______________________________________ _______ ___________
| P R O D U C T  /  L I C E N S E       | Q T Y | P R I C E |
|_______________________________________|_______|___________|
|                                       |       |           |
|_______________________________________|_______|___________|
|                                       |       |           |
|_______________________________________|_______|___________|
|                                       |       |           |
|_______________________________________|_______|___________|
|                                       |       |           |
|_______________________________________|_______|___________|
| T O T A L                                     |           |
|_______________________________________________|___________|

[ ] Bankcard  [ ] Mastercard  [ ] Visa  [ ] Cash/Cheque/Draft

Credit Card No  _____ _____ _____ _____   Expiry Date ___/___

Cardholder Name _____________________________________________

Signature       ___________________________   Date __________

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