CREDIT CARD ORDER FORM - USE THIS FORM TO REGISTER BY CREDIT CARD

Credit Card orders are taken by PsL (Public Software Library).
PsL takes the orders and passes your name and address on to me.
I process your orders and send out the registration package. If
you have any questions or problems please contact ME. See the 
on-line help or About box for information on how to contact me.
PsL is not responsible for support and does not have any
technical information about this program.

Complete and send this form to PsL at:

E-mail        : 71355.470@compuserve.com
Fax           : 1-713-524-6398
Phone (voice) : 1-800-242-4PSL (7am-6pm CST)
              : 1-713-524-6394

If you order by phone be sure to mention the Product ID below.
_________________________________________________________________
Program    : My Personal Diary (32-bit)
Version    : 5.60B
Product ID : 14313

Please register me for _1_ copies @ $24.95 each = $ 24.95

                CREDIT CARD FEE           --->  + $  5.00
                          
                CHARGE THIS AMOUNT        --->    $ 29.95

Name       : 

Address    : 


Phone/Email: 

Card Type  :   [ ] VISA  [ ] MASTERCARD  [ ] DISCOVER  [ ] AMEX

Card #     : 
Exp. Date  :

Signature  __________________________________________

PLEASE DOUBLE CHECK YOUR CREDIT CARD INFORMATION BEFORE SENDING.
MAKE SURE THE NAME IS THE SAME AS THE NAME ON THE CREDIT CARD.