BWI BUSINESS WORLD INC.

#111-20120 64th Ave. Langley, B.C.

PH:604-532-0500 FAX: 604-532-0567

TOLL FREE PHONE: 1-800-287-9753

TOLL FREE FAX: 1-866-532-9125

COMPANY NAME:    __________________________________________________

CONTACT PERSON: __________________________________________________

ADDRESS:                  ___________________________________________________

PHONE:                       ___________________________________________________

FAX:                             ___________________________________________________

TAKE THE TIME TO FILL IN YOUR MAKES & MODELS AND RECEIVE

24 PENS AND 24 PENCILS FREE ON YOUR NEXT ORDER OVER $100.00!

POS SYSTEM           MAKE:      _________________________________________________

                                   MODEL:    _________________________________________________

CASH REGISTER   MAKE:      _________________________________________________

                                   MODEL:    _________________________________________________

VISA/DEBIT             MAKE:      _________________________________________________

                                   MODEL:    _________________________________________________

FAX MACHINE       MAKE:      _________________________________________________

                                   MODEL:    _________________________________________________

PHOTOCOPIER       MAKE:      _________________________________________________

                                    MODEL:    _________________________________________________

PRINTERS                MAKE:      _________________________________________________

                                    MODEL:    _________________________________________________

TONERS/INKJETS  MAKE:      _________________________________________________

                                    MODEL:    _________________________________________________

PLEASE FAX BACK TO 604-532-0567

OR USE OUR TOLL FREE FAX 1-866-532-9125