Mail to:                                                TD 2.11

          SYDEX
          P.O. Box 5700
          Eugene, OR  97405

                       O R D E R   F O R M


                          Name __________________________________
 
                       Company __________________________________

                       Street  __________________________________

      City, State, Zip/Country __________________________________

                               __________________________________


     Registration Fee for Single-
     System TeleDisk License       $20.00 ...........___________

     Registration Fee for Multi-
     System Site License          $150.00 ...........___________

     Additional Shipping outside
     of United States and Canada    $5.00 ...........___________
     (We airmail all foreign shipments)


     TOTAL...........................................___________

     Please indicate payment method:

     Purchase Order ___  Check/MO ___  VISA ___  MasterCharge ___

     Credit Card No._______________________________ Exp. ________

     Signature_________________________________  Date ___________

     We normally ship 5.25" 360K diskettes.  Check here if you
     need TeleDisk on 3.5" 720K diskette.................________

     Where did you learn of TeleDisk? ___________________________

     Check here if you're interested in media/file conversion
     from non-DOS systems................................________