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<HTML>
<HEAD>
<META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=iso-8859-1">
<META NAME="GENERATOR" CONTENT="Mozilla/4.04 [en] (Win95; I) [Netscape]">
<TITLE>9001</TITLE>
<!--order.htm-->
</HEAD>
<BODY TEXT="#000000" BGCOLOR="#FFFFCC" LINK="#000000" VLINK="#000000" ALINK="#000000" TOPMARGIN="0">
<CENTER><FONT SIZE=+1>Want more Information?</FONT></CENTER>
<P>Please complete this form to place an order, ask any questions, make
any comment about our service or to make a complaint. Regardless of the
reason, we would like to hear from you.
<P>All questions or requests for information will be answered by a qualified
person.
<P><A NAME="subscription"></A><B><FONT SIZE=+0>PLEASE provide the following
information with your comments.</FONT></B>
<P><FONT SIZE=-1>The reason for collecting the information in the form
is to insure that your inquiry is serviced properly.</FONT>
<PRE><FORM METHOD="post" action="mailto: carol@pobis.net">
<FONT SIZE=+0>Name&nbsp;&nbsp; :&nbsp;<INPUT name="wname" size="60">
Title&nbsp; :&nbsp;<INPUT name="wtitle" size="60">
Company:&nbsp;<INPUT name="wcompany" size="60">
Address:&nbsp;<INPUT name="waddr1" size="60">
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; :&nbsp;<INPUT name="waddr2" size="60">
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; :&nbsp;<INPUT name="waddr3" size="60">
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; :&nbsp;<INPUT name="waddr4" size="60">
City&nbsp;&nbsp; :&nbsp;<INPUT name="wcity" size="60">
Country:&nbsp;<INPUT name="wcountry" size="60">
E-Mail :&nbsp;<INPUT name="wemail" size="60">
Fax&nbsp;&nbsp;&nbsp; :&nbsp;<INPUT name="wfax" size="60">
Tel&nbsp;&nbsp;&nbsp; :&nbsp;<INPUT name="wtel" size="60">
Comments:</FONT></PRE>
<TEXTAREA name="comment" rows=8 cols=69></TEXTAREA>
<P><FONT SIZE=+0>Please click the "Send" button now.</FONT>
<P><FONT SIZE=+0>Thank you!!!</FONT>
<CENTER><INPUT TYPE="submit" VALUE="Send"><INPUT type=reset></FORM></CENTER>
<CENTER>
<HR WIDTH="100%"></CENTER>
<FONT COLOR="#000000"><FONT SIZE=-1>Return to <A HREF="content1.htm">Index
Page</A></FONT></FONT>
<P><FONT COLOR="#000000"><FONT SIZE=-2>Last Modified: November 22, 1998</FONT></FONT>
<ADDRESS>
<FONT COLOR="#000000"><FONT SIZE=-2>Questions or Comments to<A HREF="jrm@pobis.net">
Webmaster</A></FONT></FONT></ADDRESS>
</BODY>
</HTML>