                       DLL CHECK ORDER FORM

Name (Please Print) ________________________________________________________

Address ____________________________________________________________________

City _________________________ State/Province __________ ZIP _______________

Country (if not USA) ____________________ Phone/Fax ________________________

Email Address ___________________________

DISK SIZE:  [ ] 3.5" 1.4M    [ ] 5.25" 1.2M

 ------------------------------------------------------------
| Description                | Quantity | Price  | Total     |
|----------------------------+----------+--------+-----------|
| DLLCHECK 1.0               |          | $ 7.00 |           |
|----------------------------+----------+--------+-----------|
| SHIPPING USA*              |          | $ 1.00 |           |
|----------------------------+----------+--------+-----------|
| SHIPPING OTHER COUNTRIES*  |          | $ 3.00 |           |
|------------------------------------------------+-----------|
| AMOUNT ENCLOSED                                |           |
 ------------------------------------------------------------
* Add $1.00 for each additional registration

Sorry, at the moment only U.S. dollars are accepted in Cash, Check,
or Money Order.  Make checks payable to "Michael Vincze".

Mail to:  Michael Vincze
          c/o DLL Check 1.0
          5229 Wood Creek Lane
          Garland, TX   75044

Where did you get DLL Check from?

[ ] Downloaded from a BBS: BBS Name______________________________
[ ] Shareware Catalog Vendor: Vendor Name:_______________________
[ ] Retail Shareware Rack: Rack Vendor Name:_____________________ 
[ ] Ordered it from us 
[ ] A friend gave it to me 
[ ] None of the above 
[ ] Unknown
