Computer Order Form

Make checks payable to Darren Homme

Print this order form out and send it along with a check for the total amout to:

Microgenesis Software

3200 Pilgrim Lane N

Plymouth, Mn

55441

First Name:
Last Name:
Address line one:
Address line two:
City
Country
Zip code
Phone # and Email
Qty Product Name Price
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Sub Total _____________________________________________
Sales Tax (Mn Only)6.5% _____________________________________________
shipping and handling ($35 for each item) _____________________________________________
Total _____________________________________________