10-Strike LANState           (product number 2527-5): order form
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Order Information
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Unit                                     Price/Unit   Quantity   Total
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10-Strike LANState                      $149.95 US      _____   ______
(product number 2527-5)

Payment Information
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First Name:      _____________________________________________________

Last Name:       _____________________________________________________

Company:         _____________________________________________________

Street Address:  _____________________________________________________

                 _____________________________________________________

City:            _____________________________________________________

State/Province:  _____________________________________________________

Zip/Postal Code: _____________________________________________________

Country:         _____________________________________________________

Daytime Phone:   _____________________________________________________

Fax:             _____________________________________________________

Email Address:   _____________________________________________________

Payment:         __ MasterCard     __ VISA     __ AMEX     __ Discover
                 __ Check       __ Money order       __ Purchase order


For credit card orders:

Name on Card: ________________________________________________________

Credit Card Number: __________________________________________________

Expiration Date: month _______________ year (4 digits) _______________


                Signature : ____________________  Date: ______________

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Mail this form to:      Register Now!
                        Dept# 2527-5
                        PO Box 1816
                        Issaquah, WA 98027
                        United States of America

Or fax it to:           1 888 353-7276 (U.S. and Canada; toll-free)
                        1 425 392-0223 (other countries; regular)

Or just call:           1 877 353-7297 (U.S. and Canada; toll-free)
                        1 425 392-2294 (other countries; regular)

Note: Don't forget to write correct e-mail address. You will receive
a registration code via e-mail.