E-Z Access Software Ltd. Form2 P.O. 395,Calais, ME 04619-0395 7/95 Registration/Order Form For EZ-Index for Popular Photography. GST: # 899871750RT Use this form for "ALL" Credit Card orders placed through E-Z Access Software Ltd. and for all Canadian money orders and checks. Name: __________________________ Company: _______________________________ Address: __________________________________ Apt:# ________________________ M D Y Street: _________________________________ Ctry.__________ Date:___/___/____ City: ________________________________ State/Prov: ______________________ Zip/Code: ___________ Phone: _____-_______-_________ Home [] Work [] Software will be shipped on a 3«" HD diskette unless otherwise specified. Disk size: 5¬LD 360kb [] 5¬HD [] 3«DD [] (Please check one [x] ) CAN funds [ ] v1.85 For the period Jan/1985 to the present ------ $16.95 = $ [ ] v1.90 For the period Jan/1990 to the present ------ $10.60 = $ ________ Deduct 10% if a registered user of another E-Z Access Software product. Other product? ______________________________________ $ ________ (ONLY applicable when order is placed through E-Z Access Ltd.) Registered Users Only: If an update what is the version # and last month indexed in your registered copy? v ____ M ___ Y _____ Updates are $7.95 -> $ ________ Shipping and Handling and first class mail ---> $ 4.00 Add 7% GST to all Canadian orders: --------> $ ________ Add 11% PST when shipped to a New Brunswick address: --------> $ ________ Total Enclosed or charged to card $ ________ Signature: _______________________ Check One: Visa[] - MasterCard[] #_______________________ Expiry Date:___/___ Cardholder's Name as appears on Bank Card: _______________________________ (print) In Canada send this form to: E-Z Access Software Ltd. 5185 Hwy. 127, Bocabec Saint Andrews, NB. E0G 2X0