Software Products Order/Registration Form

    SciTech Software                            Date: (dd/mm/yy) ___/___/___
    G.P.O Box 4216NN
    Melbourne Victoria 3001                      ** Please read PRODUCTS.DOC
    AUSTRALIA                                       for ordering information

    Name: __________________________________________________________________
    Company: _______________________________________________________________
    Address: _______________________________________________________________
             _______________________________________________________________
             _______________________________________________________________
    Phone: _______________________  Fax: _________________________

    Register product(s) to: [ ] Company     [ ] Individual

    Computer: [ ] 386 PC [ ] 486 PC [ ] Pentium PC [ ] Macintosh
              [ ] Other (please specify) ___________________________________

    OS:       [ ] MSDOS  [ ] OS/2   [ ] Windows NT [ ] Unix
              [ ] Other (please specify) ___________________________________

    Pay By:   [ ] Cheque  [ ] Money Order

    SC Product (see PRODUCTS.DOC for details) Cost per unit  Qty    Price
       -------------------------------------- -------------  ---    ------
    A  Universal VESA VBE                     US$15 (A$20)   ___  $ ______
    A  Universal VESA VBE Source Code         US$50 (A$75)   ___  $ ______
    A  Miscellaneous freeware                 US$15 (A$20)   ___  $ ______

        Disk size:   [ ] 3.5"     [ ] 5.25"

    Subtotal:                                                     $ ______
    Shipping Charges (see PRODUCTS.DOC for amount!):              $ ______
    Total Enclosed:                                               $ ______

    I have read and agree to abide by the enclosed license agreement:

      (Signature) _____________________________________________________





















    Software Tools Order/Registration Form                      Page: 1