Private Sub EntisoftUnitsOrderFormSample()

    '
    '  Date: (month/day/year like "03/23/94")  ___________
    '
    '  Name:       _______________________________________
    '
    '  Company:    _______________________________________
    '
    '  Address:    _______________________________________
    '
    '  City:       _______________________________________
    '
    '  State/Province: ____________   ZIP/Postal Code: __________
    '
    '  Country:    _______________________________________
    '
    '  Phone #:    _______________________
    '
    '  FAX #:      _______________________
    '
    '  E-Mail Address: _______________________________________
    '
    '  Individual USE
    '
    '  Individual use license at $39 each.     # computers ____ x $39 = ______
    '
    '  MULTIPLE USE
    '
    '    2 to   9 computers at $30 each.       # computers ____ x $30 = ______
    '   10 to  24 computers at $24 each.       # computers ____ x $24 = ______
    '   25 to  49 computers at $20 each.       # computers ____ x $20 = ______
    '   50 to  99 computers at $14 each.       # computers ____ x $14 = ______
    '  100 to 500 computers at $10 each.       # computers ____ x $10 = ______
    '
    '  WRITE OR CALL FOR PRICING ON QUANTITIES OVER 500.
    '
    '  SHIPPING & HANDLING: (Postal) US & Canada $3.50/item           ________
    '
    '  Outside the United Stated, Canada, and Mexico, add $5.00       ________
    '
    '  CALIFORNIA RESIDENTS add applicable State & County Sales Tax   ________
    '
    '  TOTAL ENCLOSED FUNDS                                           ________ US$
    '
    '  CREDIT CARD PURCHASES: (Mark one) VISA ___ or MC ___ or AMEX ___
    '
    '  Card Number:    _________-_________-_________-_________
    '
    '  Expiration Date: ______/______
    '
    '  Card Holder 's Signature REQUIRED:   _______________________________________
    '
    '  TERMS:  We accept VISA or MasterCard or American Express credit cards, and
    '  Checks or Money Orders drawn on a US bank in US funds.  Corporate Purchase
    '  orders (Net 30 days) accepted for orders from large American and Canadian
    '  corporations.  ALL LICENSES MUST BE PREPAID.  ALL ORDERS OUTSIDE OF THE
    '  UNITED STATES AND CANADA MUST BE PREPAID.  Make checks or money orders
    '  payable to ENTISOFT.  Prices and terms subject to change without notice.

End Sub