ORDER FORM FOR FLASHPOINT ZIP/ZIPX FOR WINDOWS (Version 3.01.03, Preliminary Release 3 -- January 14, 1992) _____________________________________________________________________ Mail Credit Card Orders to: Mail Non-Credit Card Orders to: PsL FlashPoint Development P. O. Box 35705 Attn: Richard S. Patterson Houston, Texas 77235-5705 P. O. Box 270492 Houston, Texas 77277 Checks, Money Orders and drafts must be made payable to "Richard S. Patterson" ____________________________________________________________________ Registration/License Fee (Per User/Copy): Quantity: _____ users/copies at $49.50 $ _________ Less: Quantity Discount of ______ % ( _________ ) Less: Special Discount of ______ % ( _________ ) Total Registration/License Fees $ _________ Site License Fees (see FEES.WRI/TXT file): Quantity: ______ users/copies at $ _________ Less: Special Discount of ______ % ( _________ ) Total Site License Fees _________ Media Charges for Additional Disks Ordered: _____ 5.25" disk at $ 9.00 each $ _________ _____ 3.50" disk at $10.00 each _________ Total Media Charges _________ Special Handling Charges: International Orders: Shipping & Handling, _______ disks at $7.00 $ _________ Non-U.S. Bank Draft, Check & Money Order Fees: Canada $15.00 _________ International $25.00 _________ Total Special Handling Charges _________ TOTAL PAYMENT DUE (U.S. FUNDS): $ _________ ____________________________________________________________________ Credit Card Orders: Credit Card: Mastercard ______ Visa _______ Card Number: _________________________________ Expiration Date: ________________ Card Holder Signature: ________________________ ____________________________________________________________________ ORDER FORM FOR FLASHPOINT ZIP/ZIPX FOR WINDOWS PAGE 2 (Version 3.01.00, Preliminary Release -- January, 1992) ____________________________________________________________________ Registered Users' Names (attach additional sheets if necessary): ____________________________________________________________________ Purchaser's Name and Shipping Address (Physical and Mailing): ____________________________________________________________________ Purchaser's Authorized Representative/Contact Person and Title: ____________________________________________________________________ Telephone Number(s) (specify day and evening): ____________________________________________________________________ Current Version of Application Registering: ____________________________________________________________________ Payment Method: Cash [ ] Money Order [ ] Credit Card [ ] Check [ ] Purchase Order [ ] PO No. ______________ ____________________________________________________________________ Where or How did you learn of this product: ____________________________________________________________________ Purchaser acknowledges that purchaser or purchaser's representative has read the terms and conditions contained in the application's distribution/evaluation package as well as the applications' "About" dialog panels, and agrees to be bound thereby and by any other license agreements contained with any product registered, purchased or shipped. Furthermore, as indicated in the application's distri- bution/evaluation package, purchaser understands the software and documentation are provided "as is" and without warranty of any kind, either express or implied. Purchaser warrants and represents that the software and documentation will only be used in accordance with the aforementioned license agreements. Printed Name: ________________________________________ Signature: ________________________________________ Date: ______________