			Report Miner Table XRef Order Form
			---------------------------------
If you find Report Miner Table XRef useful, and continue to use it you are
required to register it. 

Registration may be placed by one of the following methods:

1)      SECURE order form at: 
        http://www.reportminer.com/cgi-bin/purchase.asp

2)      FAX to (973) 635 7449

3)      MAIL - send payment/order to:	
		The Retsel Group
		383 Main Street, Suite 202
		Chatham, NJ 07928
		USA
	
4)      E-Mail to paymaster@reportminer.com

Payment may be by one of the following Credit Cards:
    	Visa, MasterCard, Amercian Express, Discover
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Please provide the following information:       Date:_______________________

Name_____________________________________Company____________________________
                                         (if company registration)
Address_____________________________________________________________________

Address_____________________________________________________________________

City_____________________ State/Prov.______________Zip/Post Code____________

Country____________________________ Phone Number____________________________

E-Mail (REQUIRED) __________________________________________________________

Quantity: ____  Site Survey 			@ USD  39    Total:________

	  ____  Table XRef			@ USD  59    Total:________

	  ____  Extractor 			@ USD 179    Total:________

	  ____  RptDiff				@ USD  79    Total:________

	  ____  Report Miner Suite		@ USD 279    Total:________
		 (all of above)

    				                             Total:________
*** NOTE - Please call or e-mail for volume and discounts


Card type:  __ VISA __ MasterCard __ American Express __ Discover


Credit Card #_______________________________________ Expiration Date__________

Signature ____________________________________________________________________

Thank you for your purchase
