BLUEVIEW SOFTWARE
   --------------------------                      2300 Lawrence Ave. East
   |-      QWKBase v1.2a   -|                      BOX 80551
   |- Origin: CHANNEL 1    -|                      Scarborough, Ontario
   --------------------------                      CANADA  M1P 2R0
                                                   (416) 757-7944

Name:
     _______________________________________________________________________

Address:
        ____________________________________________________________________

City/Town:                        State/Province:
          ________________________               ___________________________

Zip/Postal Code:                         Country:
                ________________________         ___________________________

Phone Number   : (     )                    Date:
                ________________________         ___________________________

Email Address  :
                ____________________________________________________________
                (Compuserve ID / Internet / Fido-Netmail / RIME


Name of BBS or Vendor where QWKBase was obtained from:
(If bbs, please include the phone number of the BBS)

____________________________________________________________________________


Computer       :  [ ] XT    [ ] 286      [ ] 386   [ ] 486  [ ] Other
Display Card   :  [ ] VGA   [ ] SVGA     [ ] Other
CD-ROM         :  [ ] YES   [ ] NO
OS             :  [ ] DOS   [ ] WINDOWS  [ ] OS/2  [ ] Other
Disk Type      :  [ ] 5 1/4 [ ] 3 1/2


Comments/Suggestions:

____________________________________________________________________________

____________________________________________________________________________


U.S. residents send $15.00 in U.S. funds.
Ontario residents send $17.00 + 8% PST in Canadian funds.
Canadian residents send $17.00 in Canadian funds.
International orders send $20 in Canadian funds. (outside of US & Canada)


Amount enclosed:
                ____________________________________________________________

Make check or money order payable to BLUEVIEW SOFTWARE.