
                       Order Form for agSI Version 1.0
                     ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~


        (please fill in / check:)

                                              prices each    prices total

        ___ x Licence for agSI              DM 20,- / $ 15 ->  __ _____
              (you will recieve a registration code)           ^ currency

        ___ x Disk with latest version      DM  5,- / $  4 ->  __ _____
              (default 3 1/2 ")
              [ ] I want 5 1/4 " disk(s)

        Ask for discounts on quantity orders!

        Payment/Shipping:
        ( )   pre-paid (cash / cheque)                             --
        ( )   C.O.D. (only inside Germany!)       DM  5,-  ->  __ _____
        (No credit card orders as I have no way to handle them.)

                                                            =============

        Total:  -------------------------------------------->  __ _____

        [ ]  Please inform me about "major" upgrades...
             [ ] via e-mail     [ ] via letter


        Name:    ____________________________________________________

        Company: ____________________________________________________

        Address: ____________________________________________________

                 ____________________________________________________

                 ____________________________________________________

        E-Mail:  ____________________________________________________
        (accessible from the Internet)


        Date: ________________   Signature: _________________________


        Mail to:  Andreas Grgel,  Gildenstr. 4,
                  D-74074 Heilbronn,  Germany
        or (C.O.D. delivery) via e-mail (Internet) to:
                         ag@studbox.uni-stuttgart.de
