NOTE:  Only use this order form if you have a SupraFAXModem 288 that the Flasher
application indicates factory service is required to upgrade to 33.6.

NAME:	_________________________________________

ADDRESS:_______________________________________________________	
							
CITY:___________________ STATE:_____ ZIP:______	

COUNTRY:_____________________

TELEPHONE:______________  FAX:_________________	
							
Advance Service	o	Regular Service	o      Modem Serial #:			
							
DESCRIPTION				          QTY	COST	

SupraFAXModem 288, V.34 and VFC External PC	_______	x$40.00=  ________
SupraFAXModem 288, V.34 and VFC Internal PC     _______ X$40.00=  ________
SupraFAXModem 288 German/BZT                    _______ x$40.00=  ________

 Shipping Charges per modem: 	
        *-Special note for customers in the European Community/Mid-East
          and Africa.  To facilitate shipping, please utilize our new offices
          in the U.K.  Call our European offices at 
          (English) +44 (0) 1189-444444, or (French) +44 (0) 1189-444433
          to receive your return authorization and shipping options/pricing-*

  For the rest of our world-wide customers please utilize our U.S. offices
   (shipping prices from the U.S. offices)				 		
	 Advance Service add $29.95 (USA), $39.95 (Canada)	  ________	
	 Standard Service add $9.95 (USA), $16.95 (Canada)	  ________	
	 International shipping add $45.00 for UPS Express	  ________	
	 Sales Tax (WA residents add 7.6%)			  ________
							
						    GRAND TOTAL:__________
METHOD OF PAYMENT:		

MasterCard _____ Discover Card _____ 
							
Visa _____ Money Order _____
							
Credit Card Number______________________________ Exp. ____________
		
Cardholder Signature:							
							
Fax or mail the completed upgrade form to :	
       (Not for E.C. customers)
						
	Diamond Multimedia Communications						
	Attn: 33.6 Factory Upgrade						
	312 SE Stone Mill Drive, Suite 150						
	Vancouver, WA 98684  USA						
	Phone: (800) 727-8772   Fax:  (360) 604-1401