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|       Register: FaxMail for Windows, FAX_V204.ZIP, 1-713-261-0307        |
|   ElectraSoft, 3207 Carmel Valley Drive, MISSOURI CITY, TX  77459-3068   |
|==== Please Print ========================================================|
|                                                                          |
| Date___/___/___ Country__________________ Wk Phone______________________ |
|                                                                          |
| Name_____________________________________ Hm Phone______________________ |
|                                                                          |
| Address__________________________________ Fx Phone______________________ |
|                                                                _         |
| City_________________________________ State_____ ZIP____________________ |
|==========================================================================|
| Disk Size:  __3.5-1.4MB  __5.25-1.2MB  __Other__________________________ |
|-----+--------------------------------------------------------------------|
| Qty | Item                                                     Amount    |
|-----+--------------------------------------------------------------------|
|     |                                                                    |
|     | FaxMail for Windows - - - - - - - - - - - - - - - $25.00 $_____.__ |
|-----|                                                                    |
|     | OCR, Optical Character Recognition, Fax-to-text - $20.00 $_____.__ |
|-----|                                                                    |
|     | Zoom/Edit Fax, Zoom in and edit a Fax - - - - - - $10.00 $_____.__ |
|-----|                                                                    |
|     | DCX to PCX Breakup, Convert Fax to .PCX file(s) - $10.00 $_____.__ |
|-----+----------------------- or -------------------------------          |
|     | All of the above ($10.00 savings) - - - - - - - - $55.00 $_____.__ |
|-----+------------------------------------------------------------------- |
|                                                                          |
| Total Price of Merchandise  - - - - - - - - - - - - - - - - -  $_____.__ |
|                                                                          |
| Texas residents, please, add Sales Tax (8.25%)  - - - - - - -  $_____.__ |
|                                                                          |
| Registration, Shipping, and handling  - - - - - - - - -  $4.00 $____4.00 |
|                                                                          |
| Total (Pay this amount) - - - - - - - - - - - - - - - - - -  US$_____.__ |
|--------------------------------------------------------------------------|
|   __Cash         __Check         __VISA         __MC         __DISCOVER  |
|                                                                          |
| Card Number_____________________________________________ Exp Date___/___ |
|                                                                          |
| Print name as it appears on card________________________________________ |
|                                                                          |
| Signature_________________________________________ Date Today___/___/___ |
| (or name if Faxing with computer)                                        |
|==========================================================================|
| Mail Orders:                                                             |
| ElectraSoft, 3207 Carmel Valley Drive, MISSOURI CITY, TX  77459-3068     |
|                                                                          |
| Phone Orders:                                                            |
| Call ElectraSoft at 1-713-261-0307                                       |
|                                                                          |
| FAX Orders:                                                              |
| Call ElectraSoft at 1-713-499-5939,11,11,11,11                           |
|                                                                          |
| Where did you here about FaxMail for Windows____________________________ |
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| Optional; to help us better serve you:                                   |
| Which Fax/Modem-Driver works best (found in your AUTOEXEC.BAT):          |
| __FM_ROCK2.COM     __FM_ROCK1.COM     __FM_ATT1I.COM     __FM_ATT2I.COM  |
| __FM_PP1.COM       __FM_CLS2I.COM     __FM_CLS2E.COM     __FM_DOVE1.COM  |
| __FM_DALAS.COM     __FM_ZOOM2.COM     __FM_ZYXEL.COM     __FM_CLAS1.COM  |
| __CAS(none) Fax/Modem Brand/Mod#________________________________________ |
| Data Speed: __1200bps __2400bps __9600bps __14400bps __Other____________ |
| FAX Speed:  __1200bps __2400bps __9600bps __14400bps __Other____________ |
| Supported: __HST __V.32 __V.32bis __V.42bis __Other_____________________ |
| Computer Brand__________________________________________________________ |
| Processor: __8088 __80286 __80386 __80486 __Other_______________________ |
| Machine Speed: __25Mhz __33Mhz __50Mhz __66Mhz __Other__________________ |
| Display Type: __CGA __EGA __VGA __SVGA __Other__________________________ |
| Floppy Drive(s): __3.5, 1.4MB __5.25 1.2MB __Other______________________ |
| HardDrive Brand/Mod#_________________________________ size____________MB |
| Bugs or suggested improvements _________________________________________ |
| ________________________________________________________________________ |
| ________________________________________________________________________ |
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