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  1.  
  2.  
  3.  
  4.  
  5.                  O R D E R   F O R M
  6.                                    GEN-645b
  7.  
  8.  
  9.            TO:  BLACKBEARD                              Date____/____/____
  10.                 1198 East Baseline #113
  11.         San Bernardino, CA 92410
  12.  
  13.  
  14.  
  15.          From:  Name _______________________________________________________
  16.  
  17.                 Address ____________________________________________________
  18.  
  19.                 City __________________________ State ________ Zip _________
  20.  
  21.                 Area Code (______)  Phone __________________________________
  22.  
  23.  
  24.  
  25.                      PRODUCT----------------   EACH-------   EXTENDED-
  26.  
  27.              "BLACKBEARD"   editor      $   15.00       _______
  28.              and collectible
  29.  
  30.              California residents add:        .90       -------
  31.              (6% state tax)
  32.  
  33.                                                 Total          $_______
  34.  
  35.  
  36.  
  37.                 --------------------- User comments ----------------------
  38.  
  39.                 I learned about BLACKBEARD from
  40.                    [ ] - Friend                    [ ] - Software product
  41.                    [ ] - Computer Club             [ ] - Computer Store
  42.            [ ] - Data Base Service         [ ] - PC-SIG
  43.            [ ] - IBM-SIG / IBMNET          [ ] - other
  44.  
  45.                 Comments or suggestions: ___________________________________
  46.                 ____________________________________________________________
  47.                 ____________________________________________________________
  48.                 ____________________________________________________________
  49.  
  50.                 problems:___________________________________________________
  51.                 ____________________________________________________________
  52.                 ____________________________________________________________
  53.                 ____________________________________________________________
  54.  
  55.