


                     O R D E R   F O R M
                                        

           TO:  JERRY A. HORTON
                P.O. BOX 274
                Whitfield, MS 39193

                Date____/____/____


         From:  Name _______________________________________________________

                Address ____________________________________________________

                City __________________________ State ________ Zip _________

                Area Code (______)  Phone __________________________________



               REGISTRATION FEE------  NUMBER -------   EXTENDED-

               "RQUERY3" @  $ 25.00   _______        ---------
                includes
                latest version

               Foreign Postage          5.00          _________

               Site License (right to copy only)
The fee structure for end user copies to be distributed with your software is:

                           1 to 5 copies -            $25 each
                           6 to 25 copies -           $20 each
                           26 to 50 copies -          $15 each
                           51 or more copies -        $10 each

(Make all checks payable to: Jerry A. Horton)

                                                      _________


                                        Total         $________

               ALLOW SIX TO EIGHT WEEKS FOR SHIPPING (worst case)


                --------------------- User comments ----------------------

                I learned about RQUERY from
                   [ ] - Friend                    [ ] - Software product
                   [ ] - Computer Club             [ ] - Computer Store
                   [ ] - Data Base Service         [ ] - PC-SIG
                   [ ] - Compuserve                [ ] - IBM/NET
                   [ ] - MicroRim                  [ ] - Other

                Comments or suggestions: ___________________________________
                ____________________________________________________________
                ____________________________________________________________
                ____________________________________________________________

                problems:___________________________________________________
                ____________________________________________________________
                ____________________________________________________________
                ____________________________________________________________

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