HyperVB Order Form

Name/Contact_______________________________________________________

Company____________________________________________________________

Street_____________________________________________________________

City_____________________________________ State/Prov_______________

Country____________________________ZIP/Code________________________

Telephone __________________________ FAX  _________________________


I would like  5 1/4" _____       3 1/2" _____  disks

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HyperVB and user license	$59.95 US x ____ 	$_______

Additional user licenses	$37.95 US x ____  	$_______

Subtotal						$_______

Michigan Residents: Add 6.0% sales tax                  $_______

Shipping & Handling    (see below)  			$_______

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						Total:	$_______US

Shipping Information
US Mail:	$5.00 first product, $2.50 each additional.
International:	$9.00 first product, $4.00 each additional.

Payment may be made by:
		US Check or Money Order
		International Money Order

Make payment to:
Data Preference
27226 Lawrence Drive
Dearborn Heights, MI 48127
Tel: (313) 278-4187  (8:00 AM to 6:00 PM EST)
CIS#: 70162,1037
