BioWIN Order and Registration Form
Please complete, print and mail with enclosed cheque or money order to:

Greg Kacy
G·Wave Solutions
1231 Pacific Blvd.
Vancouver, BC, V6Z OE2
Canada
  User Information

Date:
Name:
Address:
City:   State/Province :
ZIP/Postal Code :     Country:
Email:    Phone:

  Order

Internet Download :
CD ROM :  Quantity :

  License Fees

Internet Download - US$ 10.00 (please supply clearly written email address)

CD-ROM - US$ 15.00 (price includes shipping & handling. Please add US$ 2.00 for orders outside North America)

Enclosed check or money order should be made payable to Greg Kacy

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G·Wave Solutions - www.gwavesolutions.com