Use this orderform if you want to place a creditcard order by
fax, email or mail.

Fax to: + (1) 713-524-6398
Email to: 30768@pslweb.com
Mail to: PSL, P.O.Box 35705, Houston, TX 77235-5705

-----------------------------------------------------------------

Ship-To Name & Address:

First/Middle Name:___________________________________________

Last Name:___________________________________________________

Company Name:________________________________________________

Address line 1:______________________________________________

Address line 2:______________________________________________

City:________________________________________________________

State/Province:______________________________________________

Zip, Country:___________ , __________________________________

Phone # (voice):_____________________________________________

Your Email address:__________________________________________

Creditcard number:_____________________(MC, Visa, Amex, Discover)

Expiration- Month:_____________  Year:_______________

Enter the BANK's name and phone number from the back of the card 
or from your statement. For AMEX, just enter 'AMEX' in the blank. 
All others MUST have bank's name & phone:
 
               ______________________________________________

-----------------------------------------------------------------

Creditcard holder's name and address:

(Only fill out the spaces below if the credit card holder's name 
or address is DIFFERENT from the Ship-To name and address entered 
in the spaces above.)

Name on the card:____________________________________________

Company name:________________________________________________

Address line 1:______________________________________________

Address line 2:______________________________________________

City:________________________________________________________

State,Province:______________________________________________

Zip, Country:______________ , ___________________________

-----------------------------------------------------------------

Four Pillars 1.0 order ( Prod # 30768 ):
----------------------------------------

_______ Number of copies of Four Pillars 1.0 @ $19 each

--------------------------------------------------------

Shipping and handling (check for your choice):

__ Email registration code only : $0

__ Ship on 3.5"disk, U.S./Canada : $4

__ Ship on 3.5"disk, other countries : $6

---------------------------------------------------------

Bonus offer - PSL Monthly CD-rom:

As a bonus for ordering Four Pillars 1.0 you can get
the latest edition of "PsL's Monthly Shareware CD-ROM"
(regular price: $29.95 plus s&h) for just $10 including s&h.
(Overseas orders: shipping is $4 more.)

__ Yes, send me the PsL CD-ROM. (NOTE: 1 CD only, not a subscription.)


----------------------------------------------------------------------




    
