                  Icolib Order Form
                  =================

       Name: __________________________________________________

    Company: __________________________________________________

    Address: __________________________________________________

       City: ___________________________ State: _______________

    Country: _______________________ Post/Zip Code: ___________


Your Email Address: ___________________________________________

Where did you obtain
    the program from:  ________________________________________

Payment:
=======

                      All amounts are in US Dollars.
       PAYMENTS MUST BE BY BANK CHEQUE OR INTERNATIONAL MONEY ORDER.
(Cash is acceptable but at your risk. Certainly beats the HUGE bank charges)

   Icolib program:                      ____ copies  = $_______

     1       license   no discount. ($15.00)
     2 - 5   licenses 20% discount. ($12.00 each copy)
     6 - 20  licenses 35% discount. ($10.00 each copy)
     21 +    licenses 50% discount. ($ 7.00 each copy)

   If you wish to receive the source code (see "Registering"
   in Help) then add one of the following shipping options:
      Internet Email   ............  No Charge
      Within Australia ............  $4.00
      Overseas         ............  $6.00             $_______

                                                Total  $_______

If you are receiving the source code through the
post then specify your disk size:
                      (High Density Only)  ____ 5.25" ____ 3.5"

Payments:
========
Make your payment made out to Stephen Balogh, and send it to:

     PO Box 414
     Caulfield East
     Melbourne
     AUSTRALIA     3145

Comments:
========

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If you have access to the Internet then I can be contacted at:
                   steve@cc.monash.edu.au
