RaceBuilder© ORDER FORM

BILLING Address:
Titel: _________________________Company: _________________________________
First Name: _____________________Last Name: _______________________________
Address: _________________________________City: ___________________________
State/Province: _________________________________ ZIP/Postal Code: ___________
Country: _____________________________________Phone: _____________________
Email: ______________________________Referred by: __________________________

SHIPPING Address (write SAME, if same as Billing Address above):
Titel: _________________________ Company: ________________________________
First Name: _____________________ Last Name: ______________________________
Address: ________________________________ City: ___________________________
State/Province: _________________________________ ZIP/Postal Code: ___________
Country: ____________________________________ Phone: _____________________
Email: ______________________________ Referred by: _________________________

                       Quantity                  License                                           Subtotal
                          ____ US$49 for a single license                                          ________
                          ____ US$39 for a single license update                                ________
                          ____ US$39 for a single educational license                          ________
                          ____ US$39 for a single educational license update                 ________
                          ____ US$39 for a single license in quantities of 11 or more     ________
                          ____ US$39 for a single license update                                ________
                          ____ US$500 for a site license                                           ________
                          ____ US$500 for a site license update                                  ________
                          ____ US$400 for an educational site license                          ________
                          ____ US$400 for an educational site license update                 ________
                          ____ US$400 for a quantity site license                                ________
                          ____ US$400 for a quantity site license update                       ________
                          ____ US$5000 for a world-wide license                                 ________
                          ____ US$5000 for a world-wide license update                       ________
                          ____ US$4000 for a world-wide educational license                 ________
                          ____ US$4000 for a world-wide educational license update        ________
                          ____ US$5 additional each for RaceBuilder© software on CD ________
Total quantity: ____                                                          Total fees: __________

MONEY ORDER or CHECK: Make money order or check drawn on U.S. bank payable to: Dierk Seeburg

SEND PAYMENT TO:
Dierk Seeburg
1213 North Miller Circle
Mesa, Arizona 85203-4315
USA

Incomplete order forms cannot be processed.  The information in this document is subject to change. Go to RaceBuilder©'s home site at <http://racebuilder.homepage.com/> for more information.  Send questions, comments to dierk.seeburg@kagi.com.  RaceBuilder© 1999-2000 Dierk Seeburg.  All rights reserved.
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