Knowledge by Design - Products - Periodic TablETRIS

		Products - Periodic TablETRIS - available!	Last Updated: Jan 14, 2002

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Periodic TablETRIS -- Order Form
Date:________________________________________________________

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City/State/Zip:

How to contact you in case we have questions about your order:

Items Ordered:

Purchase Periodic TablETRIS	Version	Unit Price	Quantity	Total Price
Site license (multi-user)	Mac	US$199.00		$
	Windows 95	US$199.00		$
			Subtotal	$
			North Carolina Residents Add 6.5% Tax	$
			Shipping & handling	$ 5.00
			TOTAL	$

Payment Method: Check one below:
For orders within U.S. or Canada:
_ Personal check; _ University/school check; _ Money order; _ Purchase order (with pre-paid check only)
For orders outside U.S. or Canada:
_ International money order payable in US dollars;
_ International bank draft payable in US dollars

Sorry, we do not accept credit card or COD.

Send the completed order form and the money order or check payable to Knowledge by Design to:
Knowledge by Design
P. O. Box 30234
Winston-Salem, NC 27130-0234