                        VDS Advanced Research Group
                              P.O. Box 9393
                        Baltimore, MD 21228, U.S.A.

                             VDS Order Form
                                                                       
                                                Date: ___/___/_____

Name:________________________________________________________________

Address:_____________________________________________________________
       
        ________________City: ____________ State: _____ Zip:_________

Phone:  (      )        -                      (      )       -      

Contact Person:______________________________________________________

License Type:    ( ) Personal    ( ) Academic    ( ) Business

Number of Copies:______________

Total Amount: $19.00 x ______ (No. of Copies) = ________  + $2.95 = _______

Payment Method:  ( ) Cash    ( ) Check    ( ) Money Order

     ( ) Credit Card
         ( ) VISA  ( ) MasterCard  ( ) American Express  ( ) Discovery
         Name on Credit Card:
         Expiration Date:            Credit Card Number:

Recommended By:______________________________________________________

Comments:____________________________________________________________

         ____________________________________________________________
         
         ____________________________________________________________

* Fill in the blanks, include a money order (outside the U.S.) or check for
  the total amount and mail it to our address at the top. Allow 2 weeks
  for delivery. Mailing cash is acceptable but not recommended.
  
* To register by fax and pay using a major credit card, complete this form
  and fax it to: (717) 846-2533. PA residents must add 6% sales tax.

