CYREL ORDER FORM:      -Please print clearly-

LAST NAME:________________________ FIRST NAME: _______________________________

COMPANY (if applicable): _____________________________________________________

ADDRESS: _____________________________________________________________________

CITY: ______________________________  STATE/PROVINCE: ________________________

ZIP/POSTAL CODE: ___________________  COUNTRY: _______________________________

PHONE NR.: ( _____ ) _____ - _______  E-MAIL:  _______________________________

FAX NR.  : ( _____ ) _____ - _______  E-MAIL SYSTEM:  ________________________

COMMENTS & SUGGESTIONS: ______________________________________________________

______________________________________________________________________________

______________________________________________________________________________



ORDER FORM:

Please read all the ordering information before signing this form.
Allow 3 to 4 weeks for delivery.

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 QTY. |  CODE  |            DESCRIPTION              | UNIT PRICE |  TOTAL
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------------------------------------------------------------------|-----------
                                    Subtotal of all items ordered |
                                                                  |===========
Deduct Cdn $5.00 if you previously ordered the CyReL Catalog Disk |
                                                                  |-----------
                                    Ontario residents  add 8% PST |
                                                                  |-----------
                                    Canadian orders    add 7% GST |
                                                                  |-----------
                                    Shipping and handling charges |
                                    (See schedule in product list)|-----------

                                                                  ============
                                                            TOTAL |          |
                                                                  ============


DATE: ____ - ____ - 19____   NAME: ___________________________________________

                        SIGNATURE: ___________________________________________

Method of payment:

All orders must be prepaid. Cheque/Money Order in Canadian or U.S. funds only.
Contact  Cybercube  for orders $200 and over. Minimum Order is Cdn $10 or U.S.
$10 (Continental U.S./Canada),  U.S. $25 (Other).



PLEASE ANSWER THE FOLLOWING QUESTIONS:

COMPUTER:      CPU:       WHERE DID YOU LEARN ABOUT THIS PRODUCT:

[] ST          [] 68000   [] Magazine article/review _________________________

[] Mega ST     [] 68010   [] Magazine advertisment   _________________________

[] MEGA STE    [] 68020   [] Dealer visit ____________________________________

[] TT030       [] 68030   [] Trade show   ____________________________________

[] Falcon 030  [] 68040   [] Network _________________________________________

[] Portable    [] 68060   [] BBS     _________________________________________

                          [] Personal recommendation _________________________


WHERE WILL YOU USE THIS PRODUCT:

[] Primarily at home      [] Primarily at work     [] Both equally


MAIN APPLICATION(S):

______________________________________________________________________________

STof194/IX





                              Mail to:

                                   Cybercube Research Limited
                                   126 Grenadier Crescent
                                   Thornhill,  Ontario
                                   L4J 7V7  Canada


...................................................................o/........
Cut along the dotted line.

For terms and conditions, please refer to TERMS.TXT.
For a detailed description of the warranty, please refer to WARRANTY.TXT