ORDER FORM - USE THIS FORM ONLY TO ORDER BY CHECK & MONEY ORDER.

Program: My Personal Diary for Windows
Version: 4.53
___________________________________________________________________
Send To:                   From: (PLEASE TYPE OR PRINT CLEARLY)

Chris Maresco                    __________________________________
105 Bayview Ave.
E. Patchogue NY 11772            __________________________________

                                 __________________________________
  
                          Phone: __________________________________


Source:
                                        Number of copies: _________
 COMPUSERVE ___
        AOL ___                                         X $24.95
    PRODIGY ___
        BBS _________________     OUTSIDE US & CANADA ADD $5.00 S&H
     VENDOR _________________
      OTHER _________________           Send this amount: $________
                                        (Checks MUST be in US funds
                                             drawn on a US bank)


Media Type: 5 1/4" HD____  3 1/2" HD____  OTHER (specify) _________

Computer: ____________________      Printer: ______________________

Please supply your e-mail address if you would like to receive 
update notification by e-mail.

E-mail address: ___________________________________________________

===================================================================
Orders shipped within 24 hrs of receipt. THANK YOU FOR REGISTERING!

Please take a minute to help improve the product by noting any
problems, suggestions or comments: 
