This is the mail-order form. If you wish to place your order via credit card, click here. 

Address

Your Name:   
E-mail:      
Address:     
Address:     
City:         State:  Zip:

NOTE: Please include your email address. Your email address will only be used to contact you about the status of your order.

Product Ordered

MemTest Pro delivered via email (price: $5)

MemTest Pro & Deluxe 3.5" Floppy Image delivered via email (price: $14)
MemTest Pro & Deluxe 3.5" Floppy delivered via US mail (price: $15)

MemTest Pro & Deluxe CD-ROM delivered via email as ISO (price: $14)
MemTest Pro & Deluxe CD-ROM  delivered via US mail (price: $15)

International Orders: if you are ordering a CD or Floppy media via mail, include $3 extra; your package will be shipped via Air mail. Note that you must pay in USD.

Payment

If you pay by check, please make it payable to Alan Robinson. If you choose to send cash obscure it by wrapping the bill(s) in newspaper or some other colored/textured paper.
Comments  

(optional)
Send this form along with 
the appropriate payment to:         		 HCI Design
3983-F Miramar St
La Jolla, CA 92037