


                                O R D E R   F O R M


                                  Denker Software
                                   P. O. Box 115
                                 Isanti, MN. 55040



         Programmers PAD (ProsPAD)
         and registration:
         (Shipped on 3.5" floppy disk). . . . _____ @ $29.00 ea. $_________

                         Minnesota residents add 6.5% sales tax  $_________

         If outside the U.S. and Canada, add $5.00 for handling  $_________

                                                        Total  $___________



         (Please Print clearly or include a printed label or card.)
         (Please give First name, Middle initial & Last name.)

         Name _____________________________________________________________

         Company __________________________________________________________

         Address __________________________________________________________

         City ______________________________ State _____ Zip ______________

                                       or Country _________________________

         Phone No. _ _ _ - _ _ _ - _ _ _ _

         E-mail address ___________________________________________________


         Normally the name or company given above will be used for your
         registration. If you have a preference, please print it below.
         (It will not qualify if previously used or not fully descriptive.)

         _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _




                      Sorry, no C.O.D. orders will be accepted.
         
         Orders from outside of the UNITED STATES please send a check drawn
         on a U.S. bank in U.S. dollars.
