"Pro Motion" Order Form

Please fill in every field, print the form and send it with the
corresponding material to:
	COSMIGO
	c/o Jan Zimmermann
	Gruener Winkel 2
	D-09127 Chemnitz
	Germany

        
	  Name: ______________________________________________________

       Company: ______________________________________________________

       Address: ______________________________________________________

     	  City: ______________________________________________________

	State : ______________________________________________________

   Zip/Country: ______________________________________________________


         Phone: ____________________     Fax: ________________________

        E-mail: ______________________________________________________

The following informations are voluntary. We ask you to fill in these too,
because we will consider these informations for future developments to 
offer more efficient software.

My computer has...:
	a CPU of type
         ( ) 486	( ) 586		( ) 686
	 ( ) Pentium	( ) Pentium Pro	( ) other:_______________
	 with a clock of:____MHz

	____MB RAM
	
	a grafics-device with ____MB Video-memory
	
I use the operating system(s):
	( ) Windows 3.x			( ) Windows 95
	( ) Windows NT			( ) OS/2
	( ) OS/2 Warp			( ) MS DOS/DR DOS
        ( ) others:______________________________________



Prices depend on the number of copies ordered. 
Each copy may only be used for one(!) computer-system:
	1 Copy   $45,-			2-9 Copies $40,- each
    10-24 Copies $35,- each	      25-49 Copies $32,- each
  over 49 Copies $29,- each


I want to order the following items:
	
	Copies:	  Price per copy: 

	_______ x $_______,-
    
      + Shipping:
	( ) $3,- within Europe
	( ) $7,- outside Europe
	
      + Fee for remittance via bank/cheque-payment from outside Germany:
	( ) $10,- from within Europe
	( ) $13,- from outside Europe

      = $____,-

(If you use remittance via bank or cheque-payment, you have to pay the 
 fee your bank charges yourself!)

	Date:_____________	Signature:________________________