
               VRAMDIR for Windows 95/98 Order Form
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Given Name:                   Family Name:
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Company:
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Street:
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City:                     State:            Zip Code:
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Country:
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Email:
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               Unit Price          Quantity       Sub Total
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Email Copy          US$10     X            =
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US Floppy Copy      US$15     X            =
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Int'l Floppy Copy   US$20     X            =
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                   WA residents add 8.6% Tax
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                                       Total
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Credit Card Number:
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Expiration Date:         Cardholder Name:
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Card Billing Address:
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City:                     State:            Zip Code:
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Cardholder Signature:                           Date:
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Please fill out this form and fax it to (425)649-8277.

You can also mail it to:

Virtual Software Corporation
15016 SE 63 Street
Bellevue, WA 98006
USA

If you live in The Netherlands, Belgium, France, Germany, or
United Kingdom, and would like to pay with your local currency,
please contact BTSoftware at:

BTSoftware
Postbus 4911, 5604 CC Eindhoven, The Netherlands
Fax: +31 40 290 6460
Email: OfficeManager@BTSoftware.com
Web: http://www.btsoftware.com
