Please print using a mono-spaced font!  e.g. Courier



                               The PC Consultant
                                  PO Box 42086
                             Houston, TX 77242-2086
                                  713/826-2629 voice-mail, leave a msg
                             CompuServe: 73670,1164
                      Internet: 73670.1164@compuserve.com

  NPA Order Form

  Company Name _______________________________________________________________

  Shipping Address ___________________________________________________________

  City _____________________ ST/Prov ___________ Zip/Postal Code _____________

  Attention ____________________________________ Dept ________________________

  Telephone (include area code) _____________________




  Diskette Size?  (circle one)     3-1/2"     5-1/4"

  Methed of Payment (circle one)   check    money order    cash    credit card

  Visa/MasterCard only
  Credit Card Information   Acct # _____ _____ _____ _____  exp. date ___/___

                      Name on Card _______________________

             Card Holder Signature _______________________




  Number of NPA for DOS licenses     # ____  x $25/license    = $ ______

  Number of NPA for Windows licenses # ____  x $35/license    = $ ______

  Number of export enabled licenses  # ____  x $175*/license  = $ ______
  (requires accompanying regular license,
  either NPA for DOS or Windows!)
* Existing export license holders:  Upgrade for $75

                                                   Shipping     $  n/c

                                                      Total     $ ______

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