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  1. ELECTRONIC TECHNOLOGIES ORDER FORM  11/17/90
  2.                 PROGRAM SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE.
  3.  
  4.   RemoteControl
  5.              1 to 15 copies            $35.00 ea.
  6.             16 to 30 copies (10% off)  $31.50 ea.
  7.             31 to 49 copies (20% off)  $28.00 ea.      QUAN   PRICE   TOTAL
  8.                  50+ copies (30% off)  $24.50 ea.
  9.                                                        ____  $_____  $______                                                     ----   -----   ------
  10.   LAPTOP GasGauge
  11.              1 to 15 copies            $20.00 ea.
  12.             16 to 30 copies (10% off)  $18.00 ea.
  13.             31 to 49 copies (20% off)  $16.00 ea.      QUAN   PRICE   TOTAL
  14.                  50+ copies (30% off)  $14.00 ea.
  15.                                                        ____  $_____  $______                                                     ----   -----   ------
  16.   IRS:Log / IRS:Report
  17.              1 to 15 copies            $25.00 ea.
  18.             16 to 30 copies (10% off)  $22.50 ea.
  19.             31 to 49 copies (20% off)  $20.00 ea.      QUAN   PRICE   TOTAL
  20.                  50+ copies (30% off)  $17.50 ea.
  21.                                                        ____  $_____  $______
  22. -----------------------------------|
  23. VISA/MC orders  1-800-325-7379     |      Michigan residents add 4%  $______
  24. Information:    1-313-656-0630     |
  25.                                    |       Add $4 shipping/handling  $  4.00
  26. Or mail to:                        |
  27.   Charles Eglinton                 |  Add $2 for each 3.5" diskette  $______
  28.   c/o Electronic Technologies      |
  29.   3985 S. Rochester Road, Ste. H   |                         TOTAL:  $______
  30.   Rochester, MI  48307             |
  31. ------------------------------------------------------------------------------
  32.  
  33.       NAME:____________________________________________________
  34.  
  35.    ADDRESS:____________________________________________________
  36.  
  37.       CITY:____________________________________________________
  38.  
  39.      STATE:________________________  ZIP CODE:_________________
  40.  
  41.      PHONE:________________________
  42.  
  43.  
  44.     PLEASE ANSWER THESE QUESTIONS SO THAT WE MAY SERVE YOU BETTER:
  45.  
  46.     WHAT IS THE NAME & PHONE OF THE
  47.     BBS WHERE YOU FOUND THIS PROGRAM?__________________________________
  48.  
  49.     WHAT KIND OF COMPUTER DO YOU USE?__________________________________
  50.  
  51.     WHAT KIND OF MODEM DO YOU USE?_____________________________________
  52.  
  53.     WHAT IS YOUR OCCUPATION?___________________________________________
  54.  
  55.     HOW DO YOU INTEND TO USE THIS PROGRAM?_____________________________
  56.  
  57.     DO YOU FEEL THE REGISTRATION IS TOO HIGH, OKAY or TOO LOW?_________
  58.