====================| Mouse Odometer Order Form |===================


Name: ______________________________________________________________ 

Street Address: ________________________________________ Apt. ______

City: _________________________________ State / Province: __________ 

Zip / Postal Code: _______________ Country (if not U.S.): __________

Phone: ___________________ E-Mail Address: _________________________


Where did you obtain your copy of Mouse Odometer? __________________

____________________________________________________________________


Comments or suggestions related to Mouse Odometer: _________________

____________________________________________________________________


--------------------------------------------------------------------
 QTY.  |        DESCRIPTION          | UNIT PRICE | EXTENDED PRICE
--------------------------------------------------------------------
  1    | Mouse Odometer Registration |    $5.00   |     $5.00
--------------------------------------------------------------------
                                     |    TOTAL   |     $5.00
                                     -------------------------------

***  Make checks or money orders drawn on a U.S. bank and payable in
     U.S. funds to GadgetWare.

***  Please allow about two weeks for delivery.

MAIL YOUR PAYMENT AND THIS ORDER FORM TO:

                          GadgetWare
                          PO Box 2536
                          Pueblo, CO  81005-0536
                          USA

Thank you for your order!