ORDERING
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Print this form and fill it in.
The payment is only available by check.

NAME      ____________________________________________________
COMPANY   ____________________________________________________
STREET    ____________________________________________________
STREET    ____________________________________________________
CITY      ____________________________________________________
STATE     ____________________________ZIP_____________________
COUNTRY   ____________________________________________________
TELEPHONE ____________________________________________________
EMAIL     ____________________________________________________

PRODUCT                         DISK SIZE  COST   # OF COPIES  PRODUCT TOTAL
----------------------------------------------------------------------------
MENUEX OUTBAR WITH SRC          3.5     $35         _______      _________
                                3.5     199FF       _______      _________
                                3.5     66DM        _______      _________   
                                3.5     25         _______      _________
				3.5     EU30        _______      _________
----------------------------------------------------------------------------
MENUEX OUTBAR                   3.5     $25         _______      _________
                                3.5     119FF       _______      _________
                                3.5     50DM        _______      _________   
                                3.5     15         _______      _________
				3.5     EU18        _______      _________

You would like to receive your product by [_] Email or by [_] Post
  

Make checks payable to : Laurent BRIDELANCE
Mail to : Laurent BRIDELANCE
          9, Alle du clos des livres
          95120 ERMONT
          FRANCE
