QuikCal Order Form:

Make check or money order payable to:

Alan Johnson
124 Haywood Drive
E. Brookfield, MA 01515
(508) 867-9834
CompuServe: 76120,556


Name:            ________________________________________
Address:         ________________________________________
Address:         ________________________________________
City, ST, Zip:   ________________________________________

Quantity of QuikCal @ $15.95 (US) each: ____        Dollar Total: __________
If Massachusetts residence, 5% Sales Tax:                         __________
TOTAL AMOUNT ENCLOSED:                                            __________


We thank you for your order!

I prefer:
___ 5 1/4" diskette
___ 3 1/2" diskette

I received QuikCal from:
___ Shareware Vendor
___ CompuServe
___ Genie
___ Other On-line or Bulletin Board service: ___________________
