+----------+ (tm)
          | EasyMenu | PUBLISHING
          +----------+ ____________________________________________________
                                                               P.O. Box 346
                                                       Perrysburg, OH 43551
                                                             (419) 666-7103
          
                                 CUSTOMER ORDER FORM
          
          
          
          ____ EasyMenu (TM) - Complete ............ @ $ 49.95 ea  $ ______
          
          
          ____ License - per computer .............. @ $ 24.95 ea  $ ______
          
          
          
                                                             Subtotal______
                                                                           
             (Ohio residents please add 6.0% sales tax)           Tax______
                                                                           
                                                                           
                                                             Total $ ______
          Payment by:
          ( ) Check   ( ) MasterCard   ( ) Visa
          
          Name _________________________________________Date ______________
          
          Company _________________________________________________________
          
          Address _________________________________________________________
          
          Address _________________________________________________________
          
          City ____________________________ State ____ Zip ________________
          
          Card # _______________________________ Exp Date _________________
          
          Signature of
          cardholder ______________________________________________________
          
          Phone (______)  ___________________  DISK  (  ) 5 1/4  (  ) 3 1/2
          
          
          
          ELECTRONIC MAIL ORDERS:  Send Card #, Exp. Date, Name & address.
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                     COMPUSERVE: 76576,470    THE SOURCE: BEK548