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Please fill out all needed information on the following form.

Product Type Short Description Price Qty Total
Magic Card Plus
PCI 98
 Supports:
Dos, Windows'95, '98, Me		 $109 u.s.
Magic Card Plus
PCI 2000
 Supports:
Dos, Windows '95, '98, Me, NT, 2000, (FAT16, FAT32, NTFS)		 $149 u.s.
Magic Card Plus
WOL 2000
 Supports:
Dos, Windows '95, '98, Me, NT, 2000, (FAT16, FAT32, NTFS)		 $169 u.s.

Total Order Amount :
$u.s.
BILLING INFORMATION
SHIPPING ADDRESS (if different)
Name Name
Title Title
Company Company
Address Address
City City
State/Province State/Province
Country Country
Postal Code Postal Code
Phone Phone
Fax Fax
E-mail E-mail
CREDIT CARD INFORMATION

  I hereby authorize you to charge to my credit card as payment for the
  merchandise described above.

Visa    Mastercard    American Express    Diners

  Cardholder Name
  Exp. Date(Mo/Yr)
  Card Number


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