           R S Q ( t m )   3 . 0 3    F O R    W I N D O W S 
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                        O R D E R   F O R M 
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Please fill out the needed information below as completely as possible.

Please include check, money order, or cashiers check for $45.00, plus
$2.00 for shipping.   

California Residents please add $3.71 for state tax.

Registration Name :____________________________________________________
  (Business or First and Last personal name)
  
Street Address :_______________________________________________________

Apt. or Suite # :______________________________________________________

City :_________________________________________________________________

State :____________________  Zip Code :________________________________

Please check payment type :
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[ ] - Personal Check     [ ] - Money Order    [ ] - Cashiers Check
 
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If you would like to become an authorized dealer for RSQ(tm) 3.03, special
pricing is available.  Please call phone number below.

Please allow 2 weeks for shipping. To recieve status on your order, you
can reach Reese's Computer Service at (510)745-0668.  

Please mail payment and order form to:

                  Reese's Computer Service
                  38147 Temple Way
                  Fremont, CA 94536
                  Attn: RSQ Support
                  