ORDER FORM                                              VGAMoire v1.6i
     ----------------------------------------------------------------------

               [__] Mr.      [__] Mrs.     [__] Ms.

     Name:     ____________________________________________________________

     Address:  ____________________________________________________________

               ____________________________________________________________

               ____________________________________________________________

     Phone:    (_____)________________

     If you have a copy of VGAMoire, read the REGISTER.TXT file before
     filling out this form.  You should use the form in the REGISTER.TXT
     file unless you are already registered and want to order an update, or
     you do not have a copy of VGAMoire yet and need to obtain one.


     REGISTRATION ---------------------------------------------------------

     I want to receive the benefits of an individual registration.

     [__]  I am not a registered user.  I want to order the version 1.6i
           interim release of VGAMoire and also become a registered user
           for $15.

     [__]  I am a registered user and would like to order the version 1.6i
           interim release of VGAMoire for $10.

     Please check which diskette size you require.  If you do not check one
     or the other, you will be sent a 3.5" DSDD diskette.

           [__]  3.5" DSDD         [__]  5.25" DSDD


     SITE LICENSING -------------------------------------------------------

     We wish to obtain a site license for VGAMoire.  We understand that
     this allows us to use VGAMoire on any machine at our site.  By
     purchasing a site license, we are stating that we want to receive the
     version 1.6i interim release of VGAMoire on diskette (size indicated
     above), which we will be free to distribute and use at our site.

          FEE:      for 0 to 49 machines . . . . . . . . . $150  [__]
                    for 50 to 99 machines  . . . . . . . . $280  [__]
                    for 100 to 199 machines  . . . . . . . $415  [__]
                    for 200 or more machines . . . . . . . $525  [__]

          [__]  We already have a site license and would like to order the
                version 1.6i interim release of VGAMoire for $50.

     Site name:     _______________________________________________________

     Site
     description:   _______________________________________________________
     (optional)
                    _______________________________________________________