Order Form for agSI Version 1.1.3
                    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

     (please fill in / check:)
                                               prices each    prices total

     ___ x Licence for agSI                $ 23 / DM 30,- * ->  __ _____
           (you will recieve a registration code)               ^ currency

     ___ x 3 1/2" Disk with latest version  $ 4 / DM  5,- * ->  __ _____
           default English; [ ] also German, [ ] only German
           [ ] I want 5 1/4 " disk(s)
           outside Europe additionally   1x $ 6 / DM  8,-   ->  __ _____

     * For discounts on quantity orders, see README or online help!

     Payment/Shipping:
     ( )   pre-paid (cash / cheque)                  --             --
     ( )   C.O.D. (only inside Germany!)           DM  5,-  ->  __ _____
     (Credit cards (AmEx, VISA, Diners) soon! Ask!!)
                                                             =============

     Total:  ------------------------------------------------>  __ _____

     [ ]  Inform me about "major" upgrades [ ] via e-mail [ ] via letter

     I got agSI from... __________________________________________________

     Comments: ___________________________________________________________

              ____________________________________________________________

     Name:    ____________________________________________________________
     (Please state if you want a different name used for the reg' entry.)

     Company: ____________________________________________________________

     Address: ____________________________________________________________

              ____________________________________________________________

              ____________________________________________________________

     E-Mail:  ____________________________________________________________
     (accessible from the Internet)


     Date: __________________   Signature: _______________________________


     Mail to:  Andreas Groegel           or (C.O.D. delivery) via
               Gildenstr. 4              e-mail (Internet) to:
               D-74074 Heilbronn           ag@studbox.uni-stuttgart.de
               Germany