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  1.  ORDER FORM          
  2.         Micro Tech Specialists
  3.         P.O. Box 1885
  4.         Corvallis, OR 97339
  5.                                           
  6.  
  7.                                            QUANTITY    PRICE     PRICE
  8. DESCRIPTION                                3.5"/5.25"   EACH    EXTENDED
  9. ------------------------------------------------------------------------
  10. (Evaluation Copies are for evaluation only; Registered Copies include 
  11. latest released working program, detailed documentation and support.)
  12.    
  13. POLYROOT      Evaluation Copy               ___/___    $ 5.00   $_______
  14.                         
  15. POLYROOT      Registered Copy               ___/___    $20.95   $_______
  16.  
  17.                                                      SUBTOTAL:  $_______
  18.  
  19.                                                      SHIPPING:  $__3.50_
  20.  
  21.           COD: $3.50 * UPS 2-DAY AIR: $5.00 * Foreign: $15.00:  $_______
  22.  
  23.                                                          TOTAL  $_______
  24.  
  25. _________________________________________________________________________
  26.  
  27.  
  28. NAME___________________________________________ DATE___________________
  29.  
  30. COMPANY_______________________________________ PHONE___________________
  31.  
  32. UPS ADDRESS__________________________MAILING ADDRESS___________________
  33.  
  34. CITY_______________________________________STATE_________ZIP___________
  35.  
  36.                                    SIGNATURE___________________________
  37.  
  38. *************************************************
  39. *** Please make checks payable to :   MOUSSAOUI
  40. *************************************************
  41.  
  42. **********************************************************************
  43.  
  44. We would also appreciate any input you would care to offer about
  45. our programs.  If you have any ideas or comments that would make 
  46. them better programs, please let us know.
  47.  
  48. ______________________________________________________________________
  49.  
  50. ______________________________________________________________________
  51.  
  52. ______________________________________________________________________
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  54. ______________________________________________________________________
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  56. ______________________________________________________________________
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  58. ______________________________________________________________________
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  60. ______________________________________________________________________
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