COMmunications NETwork School and Publishing Company P.O.Box 376 Farmington, New Mexico 87499-0376 (505)325-6738 INDIGO CIS (505)326-2436 ORDER FORM for SCREEN MINDER The comercial version of all SOM-NET software is registered to one user. That users name will be placed in the software by COM-NET. Information of person placing order: Name _______________________________________ Address _______________________________________________ City ___________________ State _______ Zip ____________ Phone(____)____-______ ext._________ Title of software: Screen Minder for DOS ( ) PC ( ) 286 ( ) or 386+ ( ) Cost: New Mexico USA Non-USA Program $25.00 $25.00 $25.00 NM sales tax .058 1.45 2.50 Shipping -------- ------- ------ TOTAL $26.45 $25.00 $27.50 (US Funds) Payment by: Check ( ) MasterCard ( ) Visa ( ) Card Orders: Card Number _________________________________ Exp Date ___________ Print Name on Card ___________________________