Ver. 1.00 Name ______________________________________________________________ Address ______________________________________________________________ ______________________________________________________________ City ________________________________State _______ Zip ____________ Amount $10.00/copy Number of Copies _________ $ ________ ( ) Check or money order payable to John E. Salidis in U.S. funds ( ) VISA ( ) MasterCard ( ) 5.25" disk ( ) 3.5" disk Credit card number __________________________________ Exp date _______ Signature ___________________________________________ -------------------------------[fold back here]------------------------------- [tape] ------- | place | | stamp | | here | ------- t t a a p Just Excellent Software, Inc. p e 220 High View Lane e Media, PA 19063 ---------------------------------[fold down here]-----------------------------