GoldWave Mail Order Form

Please provide the following information:
Full Name (first & last): ______________________________
Address: _______________________________________________
         _______________________________________________
         _______________________________________________
         _______________________________________________
Country: _______________________________________________
[Telephone (with Area Code)]: __________________________
E-mail address: ________________________________________
GoldWave license: US$49, Can$50, UK£30
Payment(payable to GoldWave Inc.):
    [ ] Check enclosed
    [ ] Purchase order enclosed
    [ ] Money Order or Draft enclosed
    [ ] International Money Order sent separately
Please mail this form to the address below.  Thank you
for purchasing!
           GoldWave Inc.
           P.O. Box 51
           St. John's, NL
           CANADA  A1C 5H5