                      Neighborhood Watch (tm) Order Form
   
Please register a copy of Neighborhood Watch:    To register an order:
                                                 Call (617) 393-5460
1 Your Name [______________________________]     Fax  (617) 393-5461
  Telephone [______________________________]     or Mail this form to:

                                                 Ethosoft, Inc.
                                                 196 Boston Avenue
                                                 Medford, MA. 02155
2 LICENSE SIZE ORDERED
  Neighborhood Watch is sold on a   		+---------------------------+   
  node basis in the below increments   		|      Shipping Charges     |   
  Call for corporate/upgrade pricing.		|Domestic                   |
						|  Ground:            $6.00 |
 Nodes   Price      Nodes   Price               |  2 Day Air:        $11.00 |
+-----+---------+  +-----+----------+		|  Overnight:        $16.00 |
|   5 | $ 79.00 |  | 600 | $1995.00 |		|International (Fedex)      |	
|  10 | $119.00 |  | 800 | $2575.00 |		|  Canada/Mexico:    $25.00 |
|  25 | $209.00 |  |1000 | $3075.00 |		|  Other Int'l:      $40.00 |
|  50 | $329.00 |  |2000 | $5475.00 |		|                           |
| 100 | $495.00 |  |3000 | $7475.00 |		|COD Orders:     add  $5.00 |	
| 250 | $995.00 |  |5000 |$10975.00 |		+---------------------------+
| 400 |$1395.00 |  |5000+|   CALL   |
+-----+---------+  +-----+----------+ [_____] Nodes @ Price of: | [       ] | 
                              Mass. residents add 5% Sales Tax: | [       ] |
                         			      Shipping: | [       ] |
                         			    COD Orders: | [       ] |
     				                   Grand Total: | [       ] |
3 BILL TO							+-----------+
  Name:       [____________________________________________]
  Company:    [____________________________________________]
  Street:     [____________________________________________]
              [____________________________________________]
  City:       [____________________________________________]
  State, Zip: [____________________________________________]

4 SHIP TO (if different than above)
  Name:       [____________________________________________]
  Company:    [____________________________________________]
  Street:     [____________________________________________]
              [____________________________________________]
  City:       [____________________________________________]
  State, Zip: [____________________________________________]

5 PAYMENT     We accept company purchase orders (credit subject to approval)
  MasterCard, VISA, American Express, COD, checks, & money orders (check one).
  P.O. # [_____________________________________]
  [_] VISA  [_] MC  [_] AmEx  [_] Check  [_] Money Order  [_] COD
  Credit Card # [_____________________________________]  Expiration [_______]
  								      MM/YY
  Signature     [_________________________________________]