DLL Master Order Form

Please register me (us) as a licensed owner of DLL Master:

Name:           ____________________________________________________

Company:        ____________________________________________________

Address:        ____________________________________________________
		
		____________________________________________________

City:           _______________________ State: ______ Zip: _________

Country:        ___________________

Date:           ___________________
		
			1 copy                           $     25
			2-10 copies      add $22 each    $__________
		       11-30 copies      add $19 each    $__________
		       31-60 copies      add $16 each    $__________
		       61-100 copies     add $13 each    $__________
		       (100+ copies obtain quote)
		       S&H  $3 (outside N. America $5)   $__________
		       CA Tax 7.25% (LA County 8.25%)    $__________
		       Check Total (U.S. dollars)        $__________

    ( ) 3.5" disk   ( ) 5.25" disk

First acquired or learned about DLL Master from:
    ( ) Friend  ( ) Coworker    ( ) Catalog     ( )BBS:_____________
    ( ) Other_______________________________________________________
							      10-3.0
    Send to:    Shaftel Software
		P.O. Box 12485
		La Crescenta, CA 91224-5485