PC-Write Advanced Level 4.1 Order Form

Send to: Quicksoft, Inc. - 300 Queen Anne N. #224 - Seattle, WA 98109 - U.S.A.

Phone Orders, Mon-Fri, 7am-5pm Pacific time: 800-888-8088 or 206-282-0452
FAX Orders, any time: 206-286-8802

      Shipping Address for this Order:
Name: _______________________________________________________________
Company: ____________________________________________________________
Address: ____________________________________________________________
City, State/Province: _______________________________________________
ZIP/Postal Code, Country: ___________________________________________
Day phone:  (______)_________________________________________________

      Registered User Mailing Address (if different):
Name: _______________________________________________________________
Company: ____________________________________________________________
Address: ____________________________________________________________
City, State/Province: _______________________________________________
ZIP/Postal Code, Country: ___________________________________________
[ ] Use for Quicksoft mail only

Quantity Item                                           Price   Total

 _____   PC-Write 4.1 Registered User Package:         $ 69.00 ______
         Disks, License to Use, Getting Started booklet,
         Reference Manual, one year of Technical Support
         (quarterly newsletter, support via mail, FAX, or
         phone, and 20% off price of Quicksoft products).

 _____   PC-Write 4.1 Additional User Package:         $ 39.00 ______
         All the above except Technical Support;
         Registered Users only.

 _____   Wizard's Kit, with registration only:         $ 29.60 ______

                                               SUB-TOTAL:  $_________
Add for Shipping & Handling:
  U.S. (lower 48)  add $ 5/Package
  AK, HI & Canada  add   8/Package
  Other Int'l      add  19/Package; 25/package with Wizard's Kit.
Purchase Orders    add   5 (available only in U.S. & Canada on approval)
UPS C.O.D. Order   add   5 (available only within U.S.)
Rush handling      add   5 (plus rush shipping charges)
Wash. state orders add 8.2% sales tax
                                     TOTAL (U.S. dollars): $_________
Call for larger order discounts!

Disk Size:  [ ] 5.25"   [ ] 3.5"

Payment:    [ ] Check   [ ] VISA/MC    [ ] PO    [ ] C.O.D.
(if choosing PO method, please provide PO# and billing address, also)

VISA/MC/PO#:______________________________________  Exp. Date:_______
Signature:  ______________________________________

Thank you for your order!