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SCREEN SAVER ORDER FORM: EPIPHANIES OF THE GODDESS v1.0

         To order, simply fill out this form and mail to: 
                                                             
REALITY SOFTWARE, P.O. BOX 105, WALDOBORO, ME 04572-0105 U.S.A. 

3 1/2" HD Disks Only - Quantity _____ x $US15 =  Total ______ 

NOTE: Reality Software is a small company and cannot accept
credit cards or bank drafts in foreign currencies. Please remit in 
$US or International Money Order with such drafts made out to Ben
Blumenberg. Price includes shipping and handling costs 
to anywhere on this planet. Residents of the state of Maine,
please add the 6% sales tax. 

NAME ______________________________________________________

COMPANY ___________________________________________________

ADDRESS __________________________________________________

TOWN/CITY _________________________________________________

STATE/PROVINCE ____________________________________________

ZIP or POSTAL CODE _______________COUNTRY _________________

Where did you acquire epiph1wn.zip? _________________________

Internet E-mail address for announcements, catalogs, etc.

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