Ordering

ChemPen and ChemPen3D Order Form Check or Money Order Drawn on U.S. Bank in U.S. Funds Payable to Hilton Evans
Versions 2823 and 2826 are shipped Air Mail on 3.5" disk(s).

Name:________________________________________________________________________

Address:______________________________________________________________________

Town/City: ____________________________________________________________________

State:________________________________Zip Code ____________Email_______________

Phone Day:____________________________Phone Evening__________________________

Operating System Windows 95____ 98____ NT_____

ChemPen (2822) copies: ______ X $39 E-Mail Shipping Total __________

ChemPen (2823) copies: ______ X $39 +$2 Shipping($4 Intl)Total __________

ChemPen+(4534) copies: ______ X $59 via E-MailTotal __________

ChemPen+(4534) copies: ______ X $59 +$2 Shipping($4 Intl)Total __________

ChemPen3D(2825) copies: ______ X $99 via E-Mail Shipping Total __________

ChemPen3D(2826) copies: ______ X $99 +$2 Shipping ($4 Intl) Total __________

NMRPen(4033) copies: ______X $199 + $2 Shipping($5 Intl) Total____________