Sub Rosa Publishing Inc.                                   SR-Info Order Form

SEND ORDER TO:
   Sub Rosa Publishing Inc.               PHONE (416) 398-8414
   Unit 34-1170 Sheppard Ave. W.      24-hr Fax (416) 630-7384
   Downsview, ONTARIO                 U.S. 800 line:  426-3475
   CANADA           M3K 2A3


SHIP TO:                                REGULAR MAILING ADDRESS IF DIFFERENT:

       Name: ________________________          Name: ________________________

    Company: ________________________       Company: ________________________

    Address: ________________________       Address: ________________________

City,St,Zip: ________________________   City,St,Zip: ________________________

  Day Phone: (______) _______________   Night Phone: (______) _______________

QUANT ITEM                                             PRICE       TOTAL
===== ================================================ ==========  ===========

_____ Set of registered diskettes                      $ 50.00     $__________
      includes one-half hour technical support
_____ SR-Info Manual                                   $ 40.00     $__________

Diskozine - newsletter on a disk 2 copies per year     $ 25.00     $__________
Original VP-Info Manual with detailed turorials and
   sample programs (Programs also on floppy disk.)     $ 35.00     $__________
Shipping/handling per order, U.S./Canada               $  5.00     $__________
Extra for outside U.S./Canada                          $  5.00     $__________
Extra for company purchase order                       $  5.00     $__________
Rush handling availablle on request                                $__________

Ontario Orders (8% sales tax on disks and manuals only)            $__________

                                              TOTAL (U.S. Dollars) $
                                                                   ===========

DISK SIZE: [_] 360k 5.25"     [_] 720k 3.5"

PAYMENT: [_] Check (U.S./Canada bank)   [_] VISA    [_] MC   [_] Company PO

VISA/MC/PO Number: _______________________  VISA/MC Expiry Date: ___/___/9___

  Name on Card/PO: __________________________________________________________

Cardholder Signature: ______________________________________________

                                                    Thank you for your order!


