Ordix Mpack Order Form
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    TO:                                   Date: ______________________

          Ordix Interactive
          P.O Box 155,
          Tanglin Post Office,
          Singapore 912407                Email: sales@ordix.com
    
    FROM:
          

      Name:     ______________________________________________________

      Reg Name: ______________________________________________________
             [Used to register stamp your program, 12 characters max]

      Email:    ______________________________________________________

      Address:  ______________________________________________________

      City:     ____________________________ State: __________________

      Country:  ____________________________ Postal Code: ____________

      Comment:  ______________________________________________________

	        ______________________________________________________

	        ______________________________________________________


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    Registration #						        $25	
   
    Software diskette at $2 each (Optional) 	           ____ x 2 = ______

    Software CD at $5 each (Optional) 		           ____ x 5 = ______
   
    Transport Fee (if purchasing diskette or CD)  			$5
   
    Total Order                                                       ______

                                                     Total Enclosed   ______

   
    Payment method:  ( ) Cash     ( ) Money order     ( ) Cash Cheque


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***We only accept U.S. Dollar cash, cash cheques, or money orders in US$***