ORDER FORM - SINGLE ORDER WinCLI V3.00 *********************************************************** For multiple copies or site licenses please call Eschalon Development Inc. at (604) 520-1543. *********************************************************** NAME/CONTACT_______________________________________________ COMPANY____________________________________________________ STREET_____________________________________________________ CITY_______________________________________________________ STATE_________________________ ZIP_____________________ TELEPHONE _______________ FAX _________________________ WinCLI license number.......................$35.00...______ US - Shipping and handling..................$ 0.00...______ Foreign - Shipping and handling.............$ 1.00...______ ========== Total in US Funds drawn on a US or Cdn. Bank.........______ VISA #_____________________________________ Exp. Date______ Name On Card_______________________________________________ Overseas orders must be money-orders in Canadian funds. Make checks or money-orders payable to: Eschalon Development Inc. Mail to: Eschalon Development Inc. 110-2 Renaissance Sq. New Westminster, BC V3M 6K3 Canada *VISA will be charged in equivalent Canadian dollars.