------------------------------------------------------------------
                    KwikDraw Order Form

                    The Human Interface
                     902 94th St. S.E.
                    Everett, WA  98208
                      (206) 348-9043
------------------------------------------------------------------


Name:    _________________________________________________________

Address: _________________________________________________________

         _________________________________________________________

City:    ________________________ State: _______ Zip: ____________

Country: __________________________ Phone: _______________________


Qty: ______ x $37.95   = $____________            Shipping Rates
                                                
Shipping (see rates)   = $____________             U.S. & Canada:
                                                  Qty 1-3:   $3.00
                                                  Qty 4-6:   $6.00
                                                  Qty 7-10:  $8.00
C.O.D. fee ($3.00)     = $____________
                                                      overseas:
Total                  = $____________            Qty 1-3:   $6.00
                                                  Qty 4-6:  $11.00
                                                  Qty 7-10: $15.00
please check one:

____ Please ship C.O.D. (U.S. only, $3.00 additional charge)

____ Check enclosed (if you are not from the U.S. or Canada then 
     please use a credit card or international money order 
     in U.S. funds) 

____ Mastercard: __________________________________ Exp: _________

____ Visa: ________________________________________ Exp: _________


Signature: _______________________________________________________

please allow 2 weeks for delivery