------------------------------[ ORDER FORM ]---------------------------------
Pow Productions
Attn: Steve Wolfe                  Contact us on the Internet:
1965 West 4055 South               http://kublai.pacificrim.net/~solaris
West Valley City, UT 84119         conan@enterprise.net
U.S.A.
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                    Prices are in AMERICAN DOLLARS.
          This order form is for orders in the USA and Canada.

  Please check the appropriate [ ] boxes below and add up the totals.

[ ] Powball (3.5" High Density disks only).................(@ $12) __________

                             USA/Canada Shipping & Handling (@ $3) 
                                      (International add $2 extra) __________

                                 Utah residents must add 6.25% tax __________

                                                    Total enclosed __________


        Name: _______________________________________________________________

     Address: _______________________________________________________________

City, ST Zip: _______________________________________________________________

     Country: ____________________  Phone: __________________________________

Please make your [ ] Check or [ ] Money Order payable to Mr. Steve Wolfe
