
                        Archivist Order Form

        Please remit to:

        Josef J. Polak
        39 Greylock Road
        Newton, MA 02165-2731


        Your Name        ______________________________________

        Company          ______________________________________

        Address          ______________________________________

        City, State, Zip ______________________________________


        MS product licensing information (from Help, About...):

        MS Excel licensed to  _________________________________

        MS Word licensed to   _________________________________

        Archivist for MS Excel 5.0+  Quantity _____ x $15.00 = ______

        Archivist for MS Word 6.0+   Quantity _____ x $15.00 = ______

                                                      Subtotal ______

                                Sales tax: MA residents add 5% ______

                                                     Total US$ ______

        Site licenses and customizations are negotiable.

        Disk Format:    ___ 3.5"        ___ 5.25"

        Thank you for your support.


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