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Text File  |  1996-04-23  |  769b  |  42 lines
  1. Remit to:
  2. =========
  3.         Infomate Inc.
  4.         1216 Whiterock St.
  5.         Ottawa, ON. K1J 1A7
  6.         CANADA
  7.  
  8.         Attn. Picture File Navigator
  9.  
  10.  
  11. Enclosed is a [ ] Check  [ ] Money Order 
  12. for [ ] CAN$12.00  [ ] US$10.00.
  13.  
  14.  
  15. Ship to:
  16. ========
  17.  
  18. Name:   _________________________________________________
  19.  
  20. Address:_________________________________________________
  21.  
  22.         _________________________________________________
  23.  
  24. City:   ___________________  Province/State: ____________
  25.  
  26. Postal code/Zip:_____________  Country: _________________
  27.  
  28.  
  29.  
  30. Optional Information: 
  31. ---------------------
  32.  
  33. Phone:  _______________________  Fax: __________________
  34.  
  35. E-Mail: ________________________________________________
  36.  
  37.  
  38.  
  39. Comments & Suggestions:
  40. =======================
  41.  
  42.