             TRUE MULTIPLE-CHOICE TEST GENERATOR
               (Write, Review, Tutor and Test)
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0198             ORDER and LICENSE FORM 4.5               0178
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Name:              ___________________________________________

Street:            ___________________________________________

City, State & ZIP: ___________________________________________

Email:             ___________________________________________

License Name:      ___________________________________________
                      (Please print, 35 characters maximum)

SINGLE-USE LICENSE: (One computer or one person.)

  Windows 3.1 SetUp         Number: _____ x $119.95*   _______
  Satisfaction Guaranteed.

*DISCOUNTS: (Check website at www.nine-patch.com)

  (Teacher: $60) __________________________________ (-)_______

SITE LICENSE:  (Contact Nine-Patch Software for site
                licenses at www.nine-patch.com.) 

SHIPPING AND HANDLING:  (Order with 3 1/2" disk.) $5   _______
                        (License only, no charge.)

In Missouri, add 6.725% sales tax or tax number:       _______
             TIN:______________________________
TOTAL (Payable to Nine-Patch Software in U.S. dollars) _______
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(_)Check    (_)Money Order    (_)Cash     (_)Purchase Order
(_)Visa     (_)MasterCard

Card Number___________________________________________________

Name on Card____________________________ Exp. Date____________

Signature_______________________________ Phone________________
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Mail: Nine-Patch Software, Box 161, Maryville, MO 64468-0161
 FAX: 816-582-8589             Email: support@nine-patch.com
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Found program by:_____________________________________________

______________________________________________________________

Intended program use:_________________________________________

______________________________________________________________

