P R O M O S 4 O R D E R F O R M DORMAN ENTERPISES 10548 DARIN RD EL PASO, TX 79925 Phone (915) 593-7927 NO COLLECT PHONE CALLS PLEASE PRICE PRICE DESCRIPTION QUANTITY EACH EXTENDED ----------------------------------------------------------------- FE - MOUSE REGISTERED COPY _____ $10.00 $_______ ONE FREE UPGRADE WHEN DISTIBUTED PLUS COPIES OF OTHER DORMAN ENTERPRISE MOUSE PROGRAMS. PROMOS4 REGISTERED COPY _____ $10.00 $_______ ONE FREE UPGRADE WHEN DISTIBUTED PLUS COPIES OF OTHER DORMAN ENTERPRISE MOUSE PROGRAMS. PROMOS/FE DONATION _____ $5.00 $_______ you do not wish a registration number but would like to help the cause Subtotal $_______ Shipping and Handling: $2.00 Special handling: OVERNIGHT $10 * Rush $5 * Foreign $10 $_______ FOR REGISTERED COPIES ONLY TEXAS residents add 8% State Sales Tax $_______ Total: $_______ Please make checks payable to : GALE DORMAN (U.S. funds only) Name: __________________________________________________________ Address:__________________________________________________________ __________________________________________________________ City: ______________________ State: _____ Zip Code: __________