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        º      O R D E R - F O R M   M I C R O S C A N   2 . 0       º
        ÈÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍÍͼ

Yes! I would like to order Microscan 2.0. Please send the latest and integral 
version of this program, including the printed manual, to: 

Name      :  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Address   :  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

             . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

             . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Country   :  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Callsign  :  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(please provide a personalized callsign if you want to use the transmit 
option, do not use general calls like 'mscan', 'sstv', 'color' etc.) 

Send me a.s.a.p. (tick your choice):

[ ]  Microscan 2.0 for fl. 95.- (US$ 55)

[ ]  Microscan 1.3 for fl. 50.- (US$ 30)

[ ]  Microscan RX interface for fl. 95.- (US$ 55)

I already have a registered version of Microscan 1.3 and would like to: 

[ ]  upgrade to Microscan 2.0 for fl. 50.- (US$ 30)

I will pay as follows:

[ ]  I have included cash (any currency will do)

[ ]  I have included an international money order made out in Dutch guilders 

[ ]  I have included a EUROcheque made out in Dutch guilders

[ ]  I will pay by Mastercard, the information on the card is

     card number : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

     expiry date : . . / . .   name: . . . . . . . . . . . . . . . . . . . . .

     house-number: . . . . .   postcode (zip code):  . . . . . . . . . . . . .

     

     Signature   : . . . . . . . . . . . . . 

[ ]  I have transferred the amount to Postbank Arnhem PSTBNL2A nr. 1747205 for 
     CombiTech in Rockanje and will pay fl. 15.- (US$ 9) extra for the costs 

[ ]  I have transferred the amount to Rabobank Rockanje nr. 35.57.02.606 for 
     CombiTech in Rockanje and will pay fl. 15.- (US$ 9) extra for the costs 

[ ]  I have included a cheque from my bank and will pay fl. 15.- (US$ 9) 
     extra for the costs 

fl. = Dutch guilders = US$ 1.71 (february 1995)

Mail or fax this form to:

CombiTech, 
Morelstraat 60, 
3235 EL  Rockanje, 
The Netherlands,
tel/fax +311814-4252