HyperVB Order Form

Name_______________________________________________________________

Company____________________________________________________________

Street_____________________________________________________________

City___________________________________ State/Prov_________________

Country____________________________ZIP/Code________________________

Telephone _________________________ FAX  __________________________

E-Mail/CIS Address__________________________


I would like (check one):  5 1/4"   _____  disk
                           3 1/2"   _____  disk
                           CIS-Mail _____
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HyperVB and developer's license		$69.95 US x ____ 	$_______

Additional developer's licenses		$37.95 US x ____  	$_______

Subtotal							$_______

Michigan Residents: Add 6.0% sales tax                  	$_______

Shipping & Handling    (see below)  				$_______

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							Total:	$_______US

Shipping Information
US Mail:			$5.00 first product, $2.50 each additional.
International:		 	$9.00 first product, $4.00 each additional.

CIS Mail:			No charge.  File will be sent "Receiver Pays".
				CIS will charge you directly for any surcharge.
				Mail product payment separately to Data Preference.


Payment may be made by:
		US Check or Money Order
		International Money Order

Make payment to:
Data Preference
27226 Lawrence Drive
Dearborn Heights, MI 48127
Tel: (313) 278-4187  (8:00 AM to 6:00 PM EST)
CIS#: 70162,1037