Product Order Form
     ____________________________________________________________
     
     Make checks payable and mail to:
     
          Toham Soft
          3472 Hathaway Ave. #144
          Long Beach, CA 90815
     ____________________________________________________________


                                     Price   Copies       Total
     
     BugTrack for Windows 95        $19.95   ______  $_________
          (Standard version)

     BugTrack for Windows 95        $49.95   ______  $_________
          (with full source code)

     CA Residents add sales tax:                     $_________
     
     Shipping/Handling:    U.S.      $2.00           $_________
                           Others    $5.00

     Total:                                          $_________
     
     Delivery Preference: [  ] Mail   [  ] CompuServe  [  ] Internet

     E-mail Addr:_______________________________________
     
     First Name: ____________________  Last Name: ____________________
     
     Company:    ________________________________  Title:______________
     
     Address:    _______________________________________
     
                 _______________________________________
     
     City:       _______________________ State ________  Zip __________
     
     Day Phone: (____)______________   Evening: (_____)_______________
     

     Comments:   ______________________________________________________

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                 ______________________________________________________
     (F-111)