PRINT >>>>>>>>>>>>>  FILL-IN  >>>>>>>>>>>>> MAIL

                             CopRadar.com -- PASSWORD

                 Name  ____________________________________ 

       E-mail Address  ____________________________________

              Company* ____________________________________

       Street Address  ____________________________________ 

                 City  ____________________________________ 

       State/Province  ____________________________________ 
    
      Zip/Postal Code  ____________________________________ 

              Country  ____________________________________ 

                Phone* ____________________________________

                  Fax* ____________________________________


              PAYMENT  $25 -- Six Months Access

   (x) PAYMENT METHOD
    Check/Money Order  ___  in U.S. currency on a U.S. bank
                            payable to Sawicki Enterprises.
    American Express®  ___
            Discover®  ___
          MasterCard®  ___
                Visa®  ___

    Credit Card Number ____________________________________

Card-validation code** ___________

       Expiration Date ____________________________________

             Signature ____________________________________

------------------------------------------------------------
             mail to:  SAWICKI ENTERPRISES
                       2648 EAST 27TH STEET
                       GRANITE CITY, IL  62040     USA
------------------------------------------------------------
  * optional.
 ** 3 digit code in the card signature panel (not AMX),
    4 digit code on front of AMX cards