Order Form: nKONVERT

Single User License (Version 1.0 -- June, 1998) 

Regular:	$25 nKONVERT 1.0 (including Visual Basic Runtimes)

Name _______________________________________________________________________ 

Title _______________________________________________________________________ 

Organization (optional)______________________________________________________ 

Street ______________________________________________________________________ 

City _____________________________ State/Province __________________________ 

Country __________________________ Postal/ZIP code _________________________ 

Phone _________________Fax _________________E-mail __________________________ 

Select one of the methods of payment below.  Purchase orders from educational institutions, government agencies, and companies will be accepted.  If you are requesting electronic delivery, please PRINT your email address.  

Number of copies_________ Per copy price $ ______ 

SOFTWARE			$_________________ 

Shipping/handling charges: E-Mail: no charge. 

Disk(s): ___	$ 5.00. Mail: ___ $ 5.00. Federal Express: ___	$15.00 

SHIPPING			$________________

SALES TAX (CA residents, 7.25%)	$ ________________ 

TOTAL			 	$ ________________ 


Signature ________________________________________________ 

Purchase Order Number ____________________________________ 

Send this order form and remittance to: 

Anthony van Leeuwen, 901 Decatur Ave., Ventura CA 93004-2232
