FAXFILE ORDER FORM

          Name 
          Last: ___________________________  First: ________________  M.I. ___
                   
          Address: ___________________________________________________________

          City: _________________________________________  State: ____________

          Zip: ________________ Phone: (________) _______________________
          
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                                     FAXFILE   _____    $25 each  _________
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                                              Shipping/Handling   __$5.00__
             
                                                       Subtotal   _________
           
                  Illinois residents please add 6.25% sales tax   _________
             
                                       Total amount of purchase   _________
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          Disk size:   _____ 5¬"   _____ 3«"      HD or LD _____
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          Please make your check or money order out to:  
                              
                              Shawn Anderson
                              PO Box 1481
                              Milan IL 61264

          Checks and money orders must be drawn on U.S. banks in U.S. funds.
          Sorry, phone orders cannot be accepted.  Prices subject to change.
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