                                  ORDER FORM
                           Personal Cards Version 1.00

   This order form is for use by individuals wishing to become
registered users of Personal Cards.  Corporations and other
institutions, please contact the Biomedical Design Centre for further
information regarding site licenses, volume discounts, dealer pricing,
and ordering via purchase order.

   Please complete the following information and return this form with
your check , money order, Visa # or Master Card # (Biomedical Design
Centre will take no responsibility for cash sent through the mail) to
the address below.  Please make all checks and money orders for Canadian
funds payable to Biomedical Design Centre.

   Registration entitles you to receive a copy of the non-shareware
release of Personal Cards Version 1.00 which supports 500 cards.

    Please submit to:  Biomedical Design Centre
                       750 Heritage Medical Research Building
                       University of Alberta
                       Edmonton, Alberta, Canada
                       T6G 2S2
                       Ph: 403-492-4870
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    <Please Type or Print Clearly>
    
        Name: __________________________________________________

     Company: __________________________________________________
    
     Address: __________________________________________________

              __________________________________________________

        City: _____________________  St or Prov: _______________

 Postal Code: ________________  Country: _______________________

Phone Number: __________________________________________________

        Date: ___-___-______
    
        Disks:  < > 3.5"   < > 5.25"

    I would like to register:
                                                                Totals

____ Copy(s) of Personal Cards Vsn. 1.00 @ $ 25.00 per copy:    $___________

 
< >    I am including a check or money order for: ___________
< >    Master Card # ____________________________ Expiry Date ________
< >    Visa Card # ______________________________ Expiry Date ________
       Signature for Credit Card orders ______________________________
