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................................________