COBOL*Express Order Form
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							_________________
							Today's date

From:	______________________________________ (Name)

	______________________________________ (Company)

	______________________________________ (Address)

	______________________________________ (Address)

	______________________________________ (City, State, Zip)

	______________________________________ (Phone number)



To:	Giraffe Systems, Inc.		(800)768-9657 ext.300  Sales
	Attn: N.A. Sales		(301)590-7485 Fax
	P.O. Box 246			(800)768-9657 ext.525  Support
	Gaithersburg, Md.   20884



COBOL*Express Lite	 . . . . . . . . . . . . at $  99.00	_________
(Includes: Manual, Hypertext Cobol reference facility,
 customer support, Additional Cobol dialects
 and customizable ANSI-85 Cobol)

			Shipping and handling       $  10.00	_________

						T O T A L	$________


Telephone orders; Please call at (800)768-9657 x300


_________________________	_________
Credit Card Number		Exp. Date

_________________________	____  VISA	____  Mastercard
Signature


_________________________	Ship to	  _______________________________
Purchase Order Number		address:
					  _______________________________

					  _______________________________

					  _______________________________

					  _______________________________

Terms:  Check or Money Order
	Credit Card
	Purchase orders (net 30)