  x-WARE5 for Web Servers Order Form       Extensions Software Corporation
  ----------------------------------       621 Boll Weevil Circle
                                           Suite 16-301
                                           Enterprise, AL  36330  USA
                                           888-EXT-SOFT   (New Sales)
                                           334-347-3991   (Sales/Info/Support)
                                           334-347-3992   (FAX)
                                           www.ext.com    (Internet Web Site)
                                           sales@ext.com  (Internet Email)

     Name: ___________________________________________________________________

  Company: ___________________________________________________________________

  Address: ___________________________________________________________________

  Address: ___________________________________________________________________

    Phone: ______________________________  FAX: ______________________________

  Web Server Type:   [  ] Microsoft IIS   [  ] Netscape   [  ] Sambar Server
                     [  ] WebSite Pro     [  ] Other _______________________

  Product Selection: [  ] x-FONE5 Phone Directory for Web Servers
                     [  ] x-LIST5 Data Manager for Web Servers
                     [  ] x-OUT5  In-Out Board for Web Servers

  License Selection: [  ]   100 Entry Single-Server License @ $  395.00 each
  (show quantity)    [  ]   250 Entry Single-Server License @ $  595.00 each
                     [  ]   500 Entry Single-Server License @ $  795.00 each
                     [  ]  1000 Entry Single-Server License @ $  995.00 each
                     [  ] Unlim Entry Single-Server License @ $ 1495.00 each
                     [  ] Unlim Entry Site License          @ $ 3995.00 each

  Shipping/Handling: $ 15.00

  Total Amount:      $ _________

  Payment Method:    [  ] Check (US Funds)
                     [  ] PO (Attached)
                     [  ] MasterCard       Card #: __________________________
                     [  ] VISA             Expires: ___________
                     [  ] AMEX/Optima
                     [  ] IMPAC            Signature: _______________________

  Notes: * Amounts shown are in US dollars.
         * US Government Agencies, Educational Institutions, Religious
           Organizations, and Non-Profit Entities receive a 20% discount.
         * Orders ship within 1 business day after receipt of order.
         * US orders ship via FEDEX Standard (1-day) or US Priority Mail.
         * Non-US orders ship via US Postal Service Air Mail.
         * Each product order consists of a 3.5" diskette with the latest
           software version plus serialized license file and printed
           operations guide.
         * Technical support via mail, phone, FAX, and Internet is provided
           at no additional cost to licensed users.
         * Software updates via Internet are provided at no additional cost
           to licensed users.
         * Extensions Software Corporation's Federal ID is #56-1827803.
         * Extensions Software Corporation's D-U-N-S ID is #00-858-7990.

