O R D E R   F O R M
								PCSIG 6.45


           TO:  BLACKBEARD                              Date____/____/____
                1198 East Baseline #113
		San Bernardino, CA 92410




         From:  Name _______________________________________________________

                Address ____________________________________________________

                City __________________________ State ________ Zip _________

                Area Code (______)  Phone __________________________________



                     PRODUCT----------------   EACH-------   EXTENDED-

		     "BLACKBEARD"   editor      $   15.00       _______
			 and collectible

                                                               ________

                                                Total          $_______




                --------------------- User comments ----------------------

		I acquired BLACKBEARD v6.45 from
                   [ ] - Friend                    [ ] - Software product
                   [ ] - Computer Club             [ ] - Computer Store
		   [ ] - Data Base Service         [ ] - PC-SIG

                Comments or suggestions: ___________________________________
                ____________________________________________________________
                ____________________________________________________________
                ____________________________________________________________

                problems:___________________________________________________
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