Mom 'N' Pop's Software
                              P. O. Box  15003
                           Spring Hill, FL  34609
                 (352) 688-9108 (9:00AM - 7:00PM EST- DAILY)
                          email: momnpop@gate.net
                                            ~ (Use ALT-H to Print Form) ~
    ______________________________________________________________________
    :     CATALOG : DISKS  :     CATALOG : DISKS  :     CATALOG : DISKS  :
    :      NUMBER : IN SET :      NUMBER : IN SET :      NUMBER : IN SET :
    :_____________:________:_____________:________:_____________:________:
    :  1 :CD064___:_1______: 10 :________:________: 19 :________:________:
    :  2 :CD090___:_1______: 11 :________:________: 20 :________:________:
    :  3 :CD041___:_1______: 12 :________:________: 21 :________:________:
    :  4 :Clear142:_1______: 13 :________:________: 22 :________:________:
    :  5 :________:________: 14 :________:________: 23 :________:________:
    :  6 :________:________: 15 :________:________: 24 :________:________:
    :  7 :________:________: 16 :________:________: 25 :________:________:
    :  8 :________:________: 17 :________:________: 26 :________:________:
    :  9 :________:________: 18 :________:________: 27 :________:________:
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                                                                     11/97
         Prices    $2.00 for 5.25 Disks      $2.50 for 3.5 Disks
 
    5.25 Disks __________ X Price _________................. + $ _________
 
    3.5 Disks ___________ X Price _________................. + $ _________
 
    Credit slips, Refunds, etc. ............................ - $ _________
 
    Shipping and Packing Costs.............................. + $ __ 6.00 _
     (CANADA add $2.00, OTHERS outside US add $7.00)         +   _________
     (C.O.D. add $6.00)                                      +   _________
 
    Other Items...._____________________________________.... = $ _________
 
    SUBTOTAL................................................ = $ __46.40___
 
    Florida Residents Add Sales Tax on SUBTOTAL............. + $ _________
        (6%, 6.5%, 7%, or 7.5% accordingly)
                                                             ---------------
    TOTAL...........(U.S. Currency ONLY).................... = $ __46.40____
 
    Ship To:
     Name____Steve Koberski   C/O S K Engineering_______________
 
     Street__27 Walnut St._________________
 
     City____Peabody_______________________State__MA_____Zip_01960__________
 
     Country__USA______________________Phone Number (978)_532-6955_VOICE____
 
      Please Ship UPS COD     
 
           Thank you for ordering from Mom 'N' Pop's Software,
     the Shareware vendor you will proudly recommend to your friends.
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