
                            Multi Module Music Player
                                  Version 1.00

                                   ORDER FORM


DISK SIZE: (Check One)       [  ]3.5" 1.4M   [  ]3.5" 720k
                             [  ]5.4" 1.2M

Quantity: payable in U.S. Dollars.

          MMMP Program...        $30.00 x ______ = $___________

          Shipping...             $7.00 x ______ = $___________

          If you use check...    $30.00 x ______ = $___________
          (commission of bank)

          Total...                                 $
                                                    ===========

                  in Japanese, Yen.

          MMMP Program...     3,000 yen x ______ = ___________ yen

          Shipping...           500 yen x ______ = ___________ yen

          If you use check...   500 yen x ______ = ___________ yen
          (commission of bank)

          Total...                                 
                                                   =========== yen

PAYMENT TYPE:(Check One)    [  ]AMEX CARD  [  ]Bank  [  ]Money Ship
                            [  ]CHECK

              for AMEX form:

                  Cardmember Acct No.__________________________________

                  Cardmember name______________________________________

                  Cardmember Valid Dates_______________________________


                  Cardmember Signature_________________________________

              for Bank:

                  In JAPAN. DAIICHI KANGYOU BANK
                  branch No.267(MACHIDA)
                  account No.1970171
                  account Name:GOLDEN WEEDS PROJECT CO.,LTD.
                               DAIHYOUTORISHIMARIYAKU YAMASAKI YUKINORI
                  phone:(JAPAN)-427-23-0005

              for Money ship:
              for CHECK:

                  Yukinori Yamasaki
                  Golden Weeds Project Co.,Ltd.
                  Peerage AOYAMA5-214
                  Machida-shi, Nakamachi4-9-8
                  Tokyo 194, JAPAN
                  Phone (+81)427-39-7672
                  FAX   (+81)427-39-7671
                  
                  When money ship,within this order form into envelope.


Name:__________________________________________________________________

Company:_______________________________________________________________

Street address:________________________________________________________

City:_____________________________________ ZIP code:___________________

Phone:______________________________ FAX:______________________________

Where did you get this program?  [  ]BBS  [  ]Friend  [  ]FTP [  ]other

            from BBS:(name)_______________________

                     (ID)_________________________

       from FTP site:(name)_______________________

       from WEB site:(name)_______________________

            other:________________________________

      (yours web address)_________________________

   (yours E-Mail address)_________________________

What do you use about machine...

CPU: [  ]386SX   [  ]386DX   [  ]486SX   [  ]486DX  [  ]Pentium  [  ]G6

     [  ]other__________________________

Cache:_________KB   Processor speed:_________MHz

RAM:__________MB   Harddisk:__________MB

Video board: [  ]CGA or lower   [  ]EGA   [  ]VGA   [  ]SVGA

             [  ]other:_________________________

Video memory:___________KB

Sound card: [  ]Sound Blaster   [  ]Sound Blaster Pro

            [  ]Gravis Ultra Sound  [  ]Gravis Ultra sound MAX

            [  ]Gravis Ultra Sound  PNP  [  ]Pro Audio Spectrum

            [  ]other__________________________________________________

And any else questions? or request?
(If you have many questions, You can send by InterNet-Mail.)
(My address is software@gwp3d.com.                         )

  _____________________________________________________________________

Thank you for filling this form out. all text on the check must be in the
english language or japanese language. Then this order form send by Air 
mail or FAX:

      by airmail... look at upper "PAYMENT TYPE for BANK" for address.

      by FAX:(+81)-427-39-7671
         ex.)from U.S.  011-81-427-39-7672

                         Golden Weeds Project Co.,Ltd.

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