
Ken Fitzpatrick                Name: __________________________________
27203 Hidden Trail North
Boerne, TX 78006-5591     (Company): __________________________________

                   	    Address: __________________________________

                               City: __________________________________
Today's
date: ___________   State, ZIP Code: __________________________________

			  (Country): __________________________________
Daytime
Phone #: _________________________  FAX #: ____________________________

Product:
   DBAwareCollection for Microsoft Visual Basic 4.0 (tm)

INDIVIDUAL USE
  * 3-1/2" Diskette with programs and documentation ............... $29   

MULTIPLE USE
  * SITE LICENSE for the use of DBAwareCollection 
    2 to    9 computers ..... at $25 each   # computers ___x 25   ______
   10 or more computers ..... at $20 each   # computers ___x 20   ______

Shipping & Handling (Postal) US & Canada $5.00/item
Outside US & Canada $12.00/item                                   ______

Add applicable State & County Sales Tax                           ______

TOTAL ENCLOSED US FUNDS                                      US$________

TERMS:
  Check, Cashier's Check or Money Order drawn on a U.S.A. bank in U.S.A. funds.
  Corporate Purchase orders (Net 30 days) accepted for software from 
  large corporations within the USA & Canada.  ALL LICENSES ARE PREPAID
  ONLY.  ALL ORDERS OUTSIDE OF THE UNITED STATES AND CANADA MUST BE
  PREPAID.  Please make remittance payable to "Ken Fitzpatrick".  
  Prices and terms subject to change without notice.

Thank you for supporting Shareware.

Microsoft Visual Basic is a registered trademark of the Microsoft Corporation.