DJS Software Product Order Form

 Name_________________________________
 
 Street Address_____________________________________________

               _____________________________________________

               _____________________________________________

 State_____  Zip________  Country (Blank If USA)____________________

 DOS Format : 3.0___  5.0___   Disk Size : 3___  5___
 
 Name Of Product(s)     Cost         Comments :_____________________________
 _____________________  _______      _______________________________________
                                     _______________________________________
 _____________________  _______      _______________________________________
                                     _______________________________________
 _____________________  _______      _______________________________________
                                     Where did you obtain this form?________ 
 _____________________  _______      _______________________________________
                 Total :
               
                Please Allow 3 to 6 Weeks For Product Delivery
 Most programs cost $5.00, but some may be different.  Be sure to enclose
 the correct amount in cash or check.  Thankyou for ordering!