F S A    O R D E R    F O R M
                                
                                
Name____________________________________________________________

Company_________________________________________________________

Address__________________________________________________________

City___________________________________  State________

Zip_________

Telephone____________________   (For questions about your order)


Product(s):   ____   StickEm                    
     
              ____   King's Corners
     
              ____   HexView


Diskette format: (Check one)     ____ 3.5"      ____ 5.25"

Quantity: ______ copies at $10.00 each.........	$__________

Shipping: ($2.00 per copy).....................	$__________

Order total....................................	$__________


Payment method (Check one):   ____ Check or money order
                              ____ MasterCard
                              ____ Visa


For credit card orders only, please provide the following:

Card number _____________________________________________

Expiration date ________________

Signature________________________________________________



Return this form to: Financial Systems Associates, Inc.
	             148 N. Washington St.
                     Delaware, Ohio  43015