To order SHRAK:		
By Fax:  
614-228-5284
By Mail
Quantum Axcess
240 North 5th Street
Suite 100
Columbus, OH  43215
Attn.: SHRAK order

					Quantity			Cost in US Dollars

SHRAK CD-ROM				______				$19.95

Shipping								_______

TOTAL									_______


Shipping & Handling Costs:

United States		$5.00	Sent via UPS  ($2.00 for each additional CD)
Canada			$5.00	Sent via the U.S. Postal Service ($3.00 for each additional CD)
Mexico			$8.00	Sent via the U.S. Postal Service ($5.00 for each additional CD)
All other Countries	$15.00	Sent via the U.S. Postal Service ($7.00 for each additional CD)

Ohio residents must add $1.15 sales tax.


Form of Payment		Check		Money Order		Credit Card (MasterCard or Visa)


Credit Card Number: _______________________________ Exp. Date: _________________

Signature: ________________________________________

To process credit card orders, include credit card number, expiration date 
and signature and fax to Quantum Axcess at 614-228-5284.  

All credit cards will be charged under the name Internet Concourse: SHRAK.

Information
	
Name:_______________________________________________________________		

Address: ____________________________________________________________	

City: _______________________________ State: ___________________________	

Zip Code: ___________________________ Country: __________________________

Phone: ______________________________  Fax: _____________________________

Email: ____________________________________

Make all checks and money orders payable to Quantum Axcess
Once orders are processed, we will fax or email confirmation.

U.S. orders should arrive in 3 - 7 business days.  All U.S. orders sent UPS 
must furnish a street address.  UPS cannot deliver to PO Boxes.

There is no shipping guarantee for international orders.  Customs 
and other delays may postpone arrival.  

DO not send credit card information over the Internet!