                      Order Form for agSI Version 1.1.0
                    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

     (please fill in / check:)
                                              prices each    prices total

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

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

     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

     I got agSI from... _________________________________________________

     Comments: __________________________________________________________

               __________________________________________________________


     Name:    ___________________________________________________________

     Company: ___________________________________________________________

     Address: ___________________________________________________________

              ___________________________________________________________

              ___________________________________________________________

     E-Mail:  ___________________________________________________________
     (accessible from the Internet)


     Date: __________________   Signature: ______________________________


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