REGISTRATION/ORDER FORM

To: ARK ANGLES            Phone: (047)588100 or Intl+61-47-588100
    P O Box 190           Fax:   (047)588638 or Intl+61-47-588638
    Hazelbrook NSW 2779   Internet:     100237.141@compuserve.com
    AUSTRALIA             CompuServe:                  100237,141

Name    _________________________________________________________

Company _________________________________________________________

Address _________________________________________________________

Town    __________________________  State ________  Code ________

Country _________________________________________________________

Phone   ___________________________  Fax ________________________

E-mail  _________________________________________________________

Where software seen or obtained _________________________________
Computer:  [ ] XT    [ ] AT/286    [ ] 386    [ ] 486    [ ] >486
Memory Size: ____________    Hard Disk Size: __________
Drives: [ ] 5¬" 360K   [ ] 3«" 720K   [ ] 5¬" 1.2M   [ ] 3«" 1.4M
Screen: [ ] Mono/Herc   [ ] CGA    [ ] EGA    [ ] VGA    [ ] >VGA
Dos Ver# _________   Windows Ver# _________   OS/2 Ver# _________
 ___________________________________________ _______ ___________
| P R O D U C T  /  L I C E N S E           | Q T Y | P R I C E |
|___________________________________________|_______|___________|
|                                           |       |           |
|___________________________________________|_______|___________|
|                                           |       |           |
|___________________________________________|_______|___________|
|                                           |       |           |
|___________________________________________|_______|___________|
|                                           |       |           |
|___________________________________________|_______|___________|
| T O T A L                                         |           |
|___________________________________________________|___________|

[ ] Bankcard   [ ] Mastercard   [ ] Visa   [ ] Cash/Cheque/Draft

Credit Card No  ______ ______ ______ ______   Expiry Date ___/___

Cardholder Name _________________________________________________

Signature       _____________________________   Date ____________

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