
           ORDER FORM FOR ALL PRODUCTS FROM DSE SOFTWARE PUBLISHING
    -----------------------------------------------------------------------
    YOU CAN FAX US OR ORDER ONLINE BY CALLING OUR FAX/BBS AT (707) 459-4484

    TO:                           FROM:
    DSE SOFTWARE PUBLISHING       ________________________________________
    POST OFFICE BOX 96            Name
    WILLITS, CA 95490-0096        ________________________________________
    USA                           Company (ONLY if ordering for a company)
                                  ________________________________________
    Voice: (707) 459-4358         Address
    FAX/BBS: (707) 459-4484       ______________________  _____  _________
                                  City                    State  Zip
    GEnie: "DSE.SOFTWARE"         ______________________  ________________
    FidoNet: 1:125/123            Phone                   Fax
    Internet: dse@pacific.net
              dse.software@genie.geis.com

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

    ORDER    DESCRIPTION                             PRICE  QTY  EXTENDED
    -------  --------------------------------------  -----  ---  --------
    20810    PB/VISION(tm) LITE                      25.00  ___  ________
    20812    PB/VISION(tm) PRO w/ manual on disk     79.00  ___  ________
 +> 20813    PB/VISION(tm) PRO w/ printed manual     99.00  ___  ________
 |  20510    MUSIC CD TOOLKIT for PowerBASIC 3.x     19.95  ___  ________
 |  20615    dseINSTALL(tm) Software Install Util.   19.95  ___  ________
 |
 |  Shipping, Handling, and Fees (Indicate Below) .............  ________
 |  Sales Tax (CA. Residents add 7.25%) .......................  ________
 |  Total Order (United States Funds ($US FUNDS) Only) ........  ________
 |
 |  DISK SIZE  SHIPPING/HANDLING/FEES     SHIPPING NOTES
 |  ---------  -------------------------  --------------------------------
 |  [X] 3.50"  [_] USA            $ 5.50  USA / SHIPPED PRIORITY MAIL
 |      ONLY   [_] CANADA         $ 5.50  VISA/MC/POSTAL MONEY ORDER ($US)
 |             [_] OVERSEAS       $10.00  SEE "TERMS OF SALE" (below)
 +-----------> [_] OVERSEAS       $20.00  OVERSEAS WITH PRINTED MANUAL

    ========================== 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 United States bank and in $US funds.
    o  Purchase Orders:  Please call for authorization.
    o  Returned check fee: $300 (for insufficient funds.        [DSE-1094]
