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  1.                       QB SoftWare Order Form
  2. ----------------------------------------------------------------------
  3.  
  4. To order please fill out the form below and mail it to:
  5.  
  6.    QB SoftWare
  7.    P.O. Box 3638
  8.    Glyndon,  MD  21071-3638
  9.  
  10.    Support BBS# (301) 526-7243
  11. ----------------------------------------------------------------------
  12.  
  13. Name           ______________________________
  14.  
  15. Street Address ______________________________
  16.  
  17. City           ______________________________
  18.  
  19. State __  ZIP _____-____
  20.  
  21. Phone Number  (   ) ___-____
  22.  
  23. ----------------------------------------------------------------------
  24.  
  25. __ Directory Manager / PM  Version 1.0 ($39.95)
  26.  
  27. ----------------------------------------------------------------------
  28.  
  29. Cost of order.                     $________
  30.  
  31. Shipping and handling.             $____2.50
  32.  
  33. Total Cost                         $________
  34.  
  35. ----------------------------------------------------------------------
  36.  
  37. Form of Payment.
  38.  
  39. __ Check.
  40.  
  41. __ Money order.
  42.  
  43. __ Purchase Order.
  44.        P.O. Number ________________________
  45.