Full Name:                                         Date:
                  ------------------------------        ---------
Contact person:
                  ------------------------------
Street:
                  ------------------------------
Zip, City:
                  ------------------------------
Country:
                  ------------------------------
eMail: 
                  ------------------------------
 
      Nils Hoyer
 
      Hopfenweg 207                    
 
      D - 22851 Norderstedt
 
      Germany



O R D E R

        Boot-Manager: BOOTMENU           DM  30,00     US$ 20,-- 
  ----   (Please fill in the
          number of systems)

  (  )  Shipping via postal mail         DM  10,00     US$  5,--
	        incl. invoice, disk
  (  )  Shipping via email               DM   0,00     US$  0,--
                                        -----------   -----------
        Total                            DM    ,00     US$   ,-- 
                                        ===========   ===========
 
Payment Options:
  (  )  Credit card (only DM):   (  )  Cash in advance
                                 (  )  Euro-cheque in advance
                                 (  )  Invoice (only to companies
       -----------------------         via postal mail; min. of
          Card owner				           5 licences)

                                    Credit card remark:
       -----------------------       processing is throuh the
          Card type (Visa...)        following company:
                                     AJS Software Anja Jurkat
                                     Zum Bauverein 28
       -----------------------       D - 45899 Gelsenkirchen
          Card number                Germany


       -----------------------      ----------------------------
          Valid thru                          Signature