
        Daniel Products Order/Registration Form
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    Name:________________________________  Title:________________

    Company:_____________________________________________________

    Address:____________________________ City:___________________

    State:___________   Zip:_____________  Country:______________

    Date:_____/_____/_____           (Fill out form completely)

    ---------------------------------------------------------------
    Product                     #     Price/ea     S&H       Total
    ---------------------------------------------------------------
    TxttoDxf                          |  20        |         |
    TxttoTxt                          |            |         |
   -----------------------------------------------------------------

                                         TOTAL ENCLOSED      __________

    Disk Size: [ ] 5-1/4"   [ ] 3-1/2"   

    Card# __________________________________     Exp. Date ________

    Signature ______________________________

    How did you hear about our Products?    [ ] BBS   [ ] Friend
    [ ] Other _____________________________________________________
                
    Mail Completed form with Payment to: Estevez Rams
                                         Garnisongasse 14-16
                                         PostFach 177
                                         1096 Wien
                                         Apt. 423
                                         Viena Austria.

    Prices subject to change without notice
    

    

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