                         SciTech Display Doctor 5.2
                           Order/Registration Form

    SciTech Software, Inc.						 ___/___/___
    5 Governors Lane, Suite D						 MM/DD /YY
    Chico, CA 95926 USA
    Toll free: 800-4UNIVBE
    Phone    : 916-894-8400
    Fax      : 916-894-9069

PLEASE PRINT OR TYPE CLEARLY!

    Name: __________________________________________________________________

    Company: _______________________________________________________________

    Address: _______________________________________________________________

             _______________________________________________________________

             _______________________________________________________________

             Zip/Postal Code_______________________ Country ________________

    Phone: ___________________________________  Fax: _______________________

    Email: _________________________________________________________________

    Register product(s) to: [ ] Company     [ ] Individual

    Pay By:   [ ] Check (USA only)  [ ] Money Order  [ ] Credit Card
               *$10.00 charge for all returned checks
    Credit Card Orders: MasterCard / Visa / American Express(circle one):

        Card Number ___________________________________ Expires ___/___

        Exact name on card (print) ____________________________________


      Price List                                 Cost        Qty   Price
      ------------------ ------------------      -----       ---   ------
      Display Doctor 5.2                         US$39.99*   ___ $ ______
      Disk & Manual                              US$10       ___ $ ______
          Disk size:   [ ] 3.5"     [ ] 5.25"

    *Includes any 5.x upgrades (available online)

      Subtotal:                                                  $ ______
      California residents add 7.25% sales tax                   $ ______
      Shipping & Handling Charges (See below for amount!):       $ ______
      Total Enclosed:                                            $ ______

    I have read and agree to abide by the enclosed license agreement and I 
    agree to be bound by my credit card agreement.

      (Signature required) ________________________________________________

SHIPPING CHARGES: If a disk & manual are ordered from outside of the 
    USA, the shipping charge is US$7 and will be delivered via airmail. 
    For orders within the USA, the shipping charge is US$3. Orders without
    disk & manual will receive a receipt and registration code via airmail
    for no additional shipping charge. Registration codes can be emailed or
    faxed for an additional $5 in the US and $8 outside the US.


To help us serve you better in the future, please take a moment to answer the 
follwing questions:
1. Where did find our program (please list forum/library or location downloaded)?
    [ ] America Online __________________
    [ ] Compuserve ____________________
    [ ] Internet ______________________
    [ ] BBS ____________________
    [ ] Other (Please specify) ___________________

2. What type of board/chip do you have? __________________

3. What feature do you like the best about our software? _________________

4. Are there specific applications that you are using UniVBE with? _______________

5. Do you have any comments or suggestions for future versions?
