DMLOGIN ORDER FORM

TO ========================         FROM =====================================
Bremer Corporation                  Name: ____________________________________
514 Balcones Woods Dr., 307-372
Austin TX 78759                  Company: ____________________________________

Telephone: 512-328-2465          Address: ____________________________________
Compuserve ID: 71614,2556
Internet ID: zboray@io.com          City: ____________________________________

                                   State: __________  Zip Code: ______________
FAX:  512-328-1218
                                 Country: ______________  Date: ______________

                         Daytime Phone #: ____________________________________

                                   FAX #: ____________________________________

                 Where you found DOSmenu: Compuserve _______  Internet _______
                                          BBS _______  Other _________________

PRICING ======================================================================
Network environment
    Per server licensing .......... Number of servers  ______  X  $45  _______

Shipping and handling ........................................... $10  _______

Texas residents add applicable State & County Sales Tax .............  _______

Total ............................................................US$  _______

PAYMENT ======================================================================
Enclose a check drawn on a US bank, a postal money order, or a cashiers check,

-- OR --

A signed company/institution purchase order,

-- OR --

[  ] Mastercard     [  ] Visa     [  ] American Express (includes Corporate)

Card number _______________________________________  Expiration date ____/____

Signature ____________________________________

==============================================================================

DMlogin  (C)Copyright 1995  Bremer Corporation             (order area: dez74)