                     "MAGUUCP v3.00C for OS/2" Order Form
                     ------------------------------------
           Complete the form, and mail it with your remittance to:

                               Gilmore Systems
                               7354 Rubio Ave.
                         Van Nuys, CA 91406 - U.S.A.
                                    - OR -
         Fax the form with credit card information to: (818) 782-2093
                                    - OR -
             Place your order with us by phone at: (818) 782-1870
                                    - OR-
    Place your order via credit card ONLINE on our BBS at: (818) 782-6290

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Quantity  Product Description                              Price      Total
--------  -----------------------------------------------  --------   --------

  ___     MAGUUCP v3.00C for OS/2                          $ 40.00    ________

  ___     Shipping/Handling (U.S.=$3, Canada=$4, Other=$5) ________   ________

  ___     Sales Tax (California Destinations Only)         ________   ________

                                                           TOTAL:   $ ________


========================================================
Ship To:                                               < Be certain to fill
                                                       < in the "Ship To"
                                                       < Information!!
                                                       <
                                                       < PURCHASE ORDERS:
                                                       < U.S.-based companies
======================================================== w/ Dunn & Bradstreet
                                                         number ONLY!


                               Telephone Number: ____________________________


                         ----------------------------
                         For Credit Card Orders Only:
                         ----------------------------

Check One:   ____ VISA    ____ MASTERCARD    ____ AMERICAN EXPRESS


Card Number: ______________________________________ Expiration Date: _________


Your (CardHolder) Name: ______________________________ Today's Date: _________


Signature of CardHolder: _____________________________________________________

