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  1.  
  2.                                 ORDER FORM           
  3.                         QwikSwitch 32bit for OS/2 2.x 
  4.  
  5. NOTE: Please refer to README.TXT for info on how to place order.
  6.  
  7.      Name:  ____________________________________
  8.  
  9.   Company:  ____________________________________
  10.  
  11.   Address:  ____________________________________
  12.  
  13.             ____________________________________
  14.  
  15.             ____________________________________
  16.  
  17.  
  18.   Phone (North America only):  (___)___-____    Fax:  (___)___-____
  19.                     
  20.   CompuServe ID:  ________________
  21.  
  22.   
  23.                                                 
  24.      CHECK                                  COPIES              TOTAL
  25.       ___  Single use individual license    _______    $29.95   _____   
  26.  
  27.       ___  Unlimited use corporate license (unlimited) $99.95   99.95
  28.  
  29. NOTE: Price includes shipping & handling
  30.  
  31.  
  32.    Enclose cheque/check or money order or complete credit card details:
  33.  
  34. NOTE: Visa only handled
  35.  
  36.          Card number:  ________________________   Expiry date: __ /__
  37.  
  38.    Cardholder's name:  ___________________________________________________
  39.  
  40.            Signature:  _______________________________
  41.  
  42.  
  43. If cheque/check or money order, make payment to:
  44.  
  45.      C TechWare Ltd.
  46.      Attn: Claude Biron
  47.      103 W.23rd Ave.
  48.      Vancouver, B.C.
  49.      V5Y-2H1
  50.