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  1.     In order to provide better support, service and programs please
  2.     fill out the following:
  3.  
  4.  
  5.                      Rolodex/2 ver 2.04 ORDER FORM
  6.  
  7.     Name    ___________________________________________________________
  8.  
  9.     Address ___________________________________________________________
  10.  
  11.     City    __________________________ State _________ ZIP ____________
  12.  
  13.     Country (if outside US) ___________________________________________
  14.  
  15.     Phone Number (optional) __________________  Circle:  Home  or  Work
  16.  
  17.     Email Address _____________________________________________________
  18.  
  19.     Circle Type of Email Address:  Internet, Compuserve, Genie, Other
  20.  
  21.     Version of Program You Are Registering (optional) _________________
  22.  
  23.     Place Where You Found Program _____________________________________
  24.      
  25.     Rolodex/2 for OS/2 2.x Registration Fee ($20.00 US)          ______
  26.  
  27.     Total Enclosed                                               ______
  28.     (Payment must be in U.S. funds)
  29.     (Checks & Money Orders prefered)
  30.  
  31.     Mail to:  Dennis Frost          
  32.               107 Davis Rd                 
  33.               Centerville, OH                  
  34.               45459
  35.  
  36.     Internet Address:   dfrost@wvuvphs1.hsc.wvu.edu
  37.                         dlfrost@miavx1.acs.muohio.edu
  38.  
  39.     BBS: Snowman's Land
  40.          (304) 599- 6653
  41.  
  42.                      *** Thank you for your support! ***
  43.