AD HOC ORDER FORM

Mail or fax this completed form, along with your payment to:

  ExLogica
  59 Golden Eagle Lane
  Littleton, CO 80127-5750
  USA
  Telephone  (303) 933-8553
  Fax        (303) 933-1075
  Internet   75136.1033@compuserve.com



_____ copies of Ad Hoc   @ $69.95 each                $ ___________

US shipping and handling @ $6.00 each                   ___________

Canada/Mexico shipping and handling @ $9.00 each        ___________

International shipping and handling @ $15.00 each       ___________

Colorado residents add 3% sales tax                     ___________

Total Payment                                         $ ___________


Payment Method:  __Mastercard  __Visa  __Check/Money Order ($US)
    
Charge Card Number  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _     Expires __/__

Signature (for charge orders)  ______________________________________


Date      _________________

Your Name ______________________________________________________________
  
Company   ______________________________________________________________

Address   ______________________________________________________________	

          ______________________________________________________________  

          _____________________________   Zip/Postal Code ______________

Country   ______________________________________________________________

Telephone  _____________________________________________________________
           (with area code) (in case of problems with your order)
  
Fax  _________________  E-Mail Address__________________________________
                                     (Internet, Compuserve ID, etc.)

How did you hear about Ad Hoc? _________________________________________

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