         DSE SOFTWARE PUBLISHING - VB/EXTENDER(tm) PRODUCT ORDER FORM
    ======================================================================

    TO:                           FROM:
    DSE SOFTWARE PUBLISHING       _________________________________________
    POST OFFICE BOX 96            Name
    WILLITS, CA 95490-0096        _________________________________________
                                  Company (ONLY if ordering for a company)
    ORDERS: (707) 459-4358        _________________________________________
                                  Address
    * * * * * * * * * * * * * *   ______________________  _____  __________
    *      SEE HELP.TXT       *   City                    State  Zip
    * for additional contacts *   ______________________  _________________
    * * * * * * * * * * * * * *   Phone                   Fax

    ================= P R O D U C T S   R E Q U E S T E D =================

    ORDER    DESCRIPTION                            PRICE  QTY  EXTENDED
    -------  ------------------------------------   -----  ---  ---------
    20500    VB/EXTENDER(tm) for VB/WIN 1.0 - 3.0   24.95  ___  _________
 |> TECHREF  DOS Programmer's Technical Reference    5.00  ___  _________
 |> SHAREBK  The Shareware Book (Marketing Guide)    5.00  ___  _________
 |
 |> (*) See "EXTRAS.TXT" for more product and media size information.

    Shipping and Handling (Indicate Below) ......................  ________
    Sales Tax (CA. Residents add 7.25%) .........................  ________
    Total Order (United States Funds ($US) Only) ................  ________

    DISK SIZE  SHIPPING/HANDLING          SHIPPING REQUIREMENTS
    ---------  -------------------------  ---------------------------------
    [_] 5.25"  [_] US MAIL        $ 4.00  USA and Candda
    [_] 3.50"  [_] PRIORITY MAIL  $ 5.50  USA (usually 2nd day delivery)
               [_] OVERSEAS       $10.00  see "TERMS OF SALE"

    ========================== CREDIT CARD ORDERS =========================

    [ ] VISA         |> TOTAL ORDER : $__________ <- enter total order here
    [ ] MASTERCARD   |> CARD HOLDER : _____________________________________
                     |> CARD NUMBER : _____________________________________
    EACH LINE MUST --|> EXPIRATION  : ___ / ___
     BE FILLED IN  --|> SIGNATURE   : _____________________________________

    ============================ TERMS OF SALE ============================

    o  All checks must be drawn on a U.S. bank and in $US funds.

    o  We accept purchase orders (net 30) from city, state, and federal
       government agencies and Fortune 500 companies in the USA & Canada.
       Purchase orders less than $100 subject to $5.00 processing fee.
       ALL INVOICES NOT PAID WITHIN 30 DAYS OF BILLING WILL BE SUBJECT
       TO A PENALTY FEE OF NO MORE THAN 15% OF THE UNPAID BALANCE. GRACE
       PERIOD IS 7 DAYS.

    o  Returned check fee: $300 (for insufficient funds)
