ORDER FORM for WinOutline v1.1


  First Name: __________________ Last Name:  __________________

  Company: ____________________________________________________

  Address: ____________________________________________________

           ____________________________________________________

  City:    __________________________ St: ____ Zip: ___________

  Country: __________________

 
                              US-Dollar / Deutsche Mark


  WinOutline v1.1 registration  $ 20.00 / DM 30.00    _______

  Shipping and Handling
    USA, Canada and Europe      $  4.00 / DM  6.00    _______

    other countries             $  8.00 / DM 12.00    _______

                                             Total:   _______


  Disk Size: ( ) 5.25" / 360K or ( ) 3.5" / 720K

  Language: ( ) English or ( ) German
 

  Comments:

  ___________________________________________________________

  ___________________________________________________________


  Please enclose a check or money order payable to Joern Galka.

  (Checks payable in US-Dollar or Deutsche Mark, US personal
  checks are welcome.)


Please send to:


  Joern Galka
  Postfach 1348
  W-4620 Castrop-Rauxel
  Germany


Please allow 4 to 6 weeks for delivery.