PC-OHIO ORDER FORM

Mail to: PC-Ohio
         PO Box 21411
         South Euclid  OH  44121

or FAX to: 216-291-2685


  -------------------------------------------------------------------------
 | Qt | Item                                               |  Each | Total |
 |-------------------------------------------------------------------------|
 |    | Shareware Extravaganza 4 Best of PC-Ohio 4 CD set  | $19.00|       |
  -------------------------------------------------------------------------|
 |    | Pocket PC Reference 5th edition                    | $14.00|       |
  -------------------------------------------------------------------------|
                                             Shipping and Handling |  3.00 |
                                                                   |-------|
                                                             Total |       |
                                                                    -------

               [ ] Check #_____

               [ ] VISA              [ ] MasterCard
               [ ] American Express  [ ] Discover


         Card Number:  _____ _____ _____ _____     Exp. Date:  ___/___


         Name: _______________________________________________________

         Address: ____________________________________________________

         City: _______________________________________________________

         State / Country: ____________________________________________

         Zip / Postal Code: __________________________________________

         Home Phone       : ___________________________________

         Work Phone       : ___________________________________


NOTE: ALL Credit Card charges will appear on your monthly Credit Card bill
      as having originated from "PC-Ohio".

         Signature:  _________________________________________________