O R D E R    F O R M

                          "QuickDrive for Windows 95"


 To
 Hennes Rohling
 Liener Hoern 13
 D-26931 Elsfleth / Germany

 Phone/FAX: (+49) (0)4404 5389 
 E-Mail:    hennes.rohling@metronet.de
            HeroWare@aol.com


 I order the follwing number of copies of "quickDrive for Windows 95": 

 ____ copies at U$ 10 each = ____________________


 Only cash send by postal mail is accepted. (No credit cards, no cheques!!!)
 
 Shipping method: ( ) per electronic mail to _____________________________
                  ( ) 3,5" disk by postal mail 
                       + U$ 2 within European Union
                       + U$ 5 any other country


 Name:____________________________________________________________________

 Registration-Name:_______________________________________________________

 Street:__________________________________________________________________

 Country & State:__________________ Postal code & City:___________________

 Electronic mail address:_________________________________________________

 How did you hear about QuickDrive? ______________________________________



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