              
              Irie Pascal Version 1.01 (US$ Order Form)

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To register Irie Pascal using US dollars fill in this form and
mail it along with a check/money order (made out to "Stuart King")
to the address below.
Use "orderuk" for registering Irie Pascal with UK pounds.
Use "orderca" for registering Irie Pascal with Canadian dollars.

If this order is for an upgrade fill in "# COPIES" but leave "AMOUNT"
blank. Please remember to fill in the Shipping and Handling section.

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PROGRAM:                  Unit Price   # COPIES            AMOUNT

Irie Pascal for Windows   US$25   X    _________         $________

Irie Pascal for DOS       US$25   X    _________         $________

Irie Pascal for Linux     US$25   X    _________         $________

Irie Pascal for FreeBSD   US$25   X    _________         $________

Irie Pascal for OS/2      US$25   X    _________         $________

Irie Pascal Professional  US$40   X    _________         $________
(includes Windows, DOS,
Linux, FreeBSD, and OS/2)

Shipping and Handling
   in US and Canada       US$5                           $________
   elsewhere              US$9                           $________

TOTAL         . . . . . . . . . . . . . . . . . . . .    $________

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MAILING ADDRESS:

Name:_____________________________________________________________

Address:__________________________________________________________

City/State/Province:______________________________________________

Country/Postal Code:______________________________________________

Telephone:_____________________________________________ [optional]

Email Address:_________________________________________ [optional]


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Send completed form along with check/money order to:

   Stuart King
   MB #247
   221 S. State Road 7
   Ft. Lauderdale, Fl 33317
   U.S.A.

Please do NOT send cash. Allow three to four weeks for delivery.
If you fill in your email address you will receive notification by email
when your order is shipped.

Thank you.
