                 ORDER FORM - Impel Master List v1.3

Name:_____________________________Date:___________________________

Company:__________________________________________________________

Address:__________________________________________________________

        __________________________________________________________

City:____________________________ State:__________ Zip:___________

Country:_________________________ Phone:__________________________

Fax:_____________________________ E-Mail:_________________________

  Impel Master List                 Price/Unit Quantity Extended
------------------------------------------------------------------
|  1 - 10 units                    |  $12.00  |        |         |
|----------------------------------|----------|--------|---------|
| 11 - 24 units                    |  $ 9.00  |        |         |
|----------------------------------|----------|--------|---------|
| Site License (25+ units)         | $255.00  |   1    |         |
|----------------------------------|----------|--------|---------|
| Source Code (VB v5.0)            | $114.00  |   1    |         |
-------------------------------------------------------|---------|
                                            Sub Total  |         |
                                                       |---------|
                              Tax (MN residents 6.5%)  |         |
                                                       |---------|
               Shipping and Handling (see rates below) |         |
                                                       |---------|
                                                Total  |         |
                                                       -----------
Shipping and Handling Rates:
------------------------------------------------------------------
  E-mail .............. $ 2.50      Canada  ............. $ 6.50
  United States ....... $ 5.00      International ....... $12.00
------------------------------------------------------------------

Payment Method (select one):
[ ] Check or Money Order (U.S. funds only) payable to
    Impel Solutions Corporation

[ ] Purchase Order (orders over $150.00 only)
    PO Number:___________________

  Remit Payment to:  Impel Solutions Corporation
                         17452 Iceland Trail
                              Suite 112
                       Lakeville, MN 55044-5641

TERMS

Payment is accepted via check or money order (U.S. funds from a
U.S. bank); company purchase order at Net 30 days for orders over
$150.00 and upon credit approval from corporations within the U.S.
and Canada (no international PO's accepted). Orders shipped via
e-mail will be validated with a follow-up delivery note. All
products are shipped on 3.5" high-density diskettes (except for
e-mail shipped orders). All orders are prepaid only. No runtime
license fees will be charged for your compiled applications with
source code purchases. Source code purchases are non-refundable.
No fees will be charged for minor fixes or updates to licensed
or source code owners of the product. Please make remittance
payable to Impel Solutions Corporation. Prices, terms and
conditions subject to change without notice.
