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  1.                       BSX International Order Form
  2.  
  3. I wish to register,  purchase or upgrade the following from BSX:
  4.  
  5.                                                 Register,    Disk size
  6.  *** Be sure to read BSXCAT.DOC for full ***    Purchase,    for Purs.
  7.  ***        pricing information.         ***   or Upgrade?      or
  8.                                                Circle one:   Upgrades:
  9.  
  10. __ copies of _________,  @ $_____ each: $_____  R / P / U   5.25 / 3.5
  11.  
  12. __ copies of _________,  @ $_____ each: $_____  R / P / U   5.25 / 3.5
  13.  
  14. __ copies of _________,  @ $_____ each: $_____  R / P / U   5.25 / 3.5
  15.  
  16. __ copies of _________,  @ $_____ each: $_____  R / P / U   5.25 / 3.5
  17.  
  18. __ copies of _________,  @ $_____ each: $_____  R / P / U   5.25 / 3.5
  19.  
  20. __ copies of _________,  @ $_____ each: $_____  R / P / U   5.25 / 3.5
  21.  
  22. Non-US, non-Can. SH charges ($3.00 US): $_____  (Pur. & Upgrades ONLY
  23.                                                  and ONLY for Purs.
  24.                                                  and Upgrades to sites
  25.                                                  OUTSIDE the US and
  26.                                                  Canada)
  27.                         For a total of: $_____
  28.  
  29.   I've enclosed a check or money order payable to ROBERT ROBERDS.
  30.  
  31.   Please ship purchased products to:          (PLEASE PRINT)
  32.  
  33.   Name:_____________________________________________________
  34.  
  35.   Street Address:___________________________________________
  36.  
  37.   City, State/Province:_____________________________________
  38.  
  39.   Zip Code:_____________     Country:_______________________
  40.  
  41.   Phone (Optional):_________________________
  42.  
  43.   MAKE CHECKS PAYABLE TO  ROBERT ROBERDS!  ROBERT ROBERDS!
  44.   I understand that registered  products  are  not  to  be  delivered,
  45.   while purchased and updated products are.
  46.  - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
  47.          Send this form along with cash, check or money order
  48.                     PAYABLE TO ROBERT ROBERDS
  49.                                to:
  50.  
  51.                     BSX International
  52.                     806 Park Ridge Rd. Apt. A8
  53.                     Durham, NC 27713
  54.  
  55.      *** PLEASE MAKE THE CHECK PAYABLE TO: ROBERT ROBERDS ***
  56.      *** DO NOT MAKE IT PAYABLE  TO  BSX INTERNATIONAL!!! ***
  57.      ***   DON'T  ***   EVEN   ***    THINK    ***   IT   ***
  58.      Please allow 1-2 weeks for delivery of purchases. Thanks!
  59. This form is optional. If you just send money, that's cool. Real cool.
  60.