O R D E R   F O R M / TriQwkInsertionReport v1.0

Checks and money orders must be payable  in  US  dollars  only  and  made
payable to Doug Henderson. To register this product,  please  print  this
order  form, fill in the appropriate information, and send it  with  your
check or money order for $7.00 to:

		  Doug Henderson
		  640 Emerson Drive
		  Mooresville, NC 28115

Be sure that you give me your personal name and BBS name EXACTLY  as  you
have them configured on your board!


	    Name: _______________________________________________________
	 Address: _______________________________________________________
		  _______________________________________________________
	    City: _______________________________________________________
      State/Prov: ________________________________  Postal Code: ________
	 Country: _______________________________________________________
    Phone Number: _______________________________________________________
	BBS Name: _______________________________________________________
BBS Phone Number: _______________________________________________________
 Fidonet Address: _______________________________________________________

  
  suggestions or: _______________________________________________________
  comments are    _______________________________________________________
  welcome         _______________________________________________________
		  _______________________________________________________
		  _______________________________________________________
		  _______________________________________________________
		  _______________________________________________________