NetCharts Order Form
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Order Form

2 Mar 1997
       Date of Order:   __________________

    Purchaser's Name:   _______________________________________
                    
        Company Name:   _______________________________________

             Address:   _______________________________________

                        _______________________________________

        Phone Number:   ____________________

          Fax Number:   ____________________

       Email Address:   _______________________________________

      IP Address(es):   _______________________________________
    (eg. 12.34.56.78)

                           Quantity    Unit Price      SubTotal

      Development Kit:     ________    x $795.00     ____________

      Server License:      ________    x $395.00     ____________

      Floppy Disk Copy:    ________    x  $10.00     ____________

                                              TOTAL  ____________

All products are distributed via the Internet. You will be sent, via email, the name of a Web server, an account name and a password when your order has been processed. Floppy disk distributions are also available for a $10.00 handling fee plus shipment charges.

You may pay for your order using Visa, Mastercard, or American Express by providing us with the following information:

Card Number:  __________________________  Exp. Date:  _______

** FOR YOUR PROTECTION, DO NOT SEND CREDIT CARD NUMBERS VIA EMAIL **

NetFactory also accepts checks drawn on U.S. banks, money orders or international traveler's checks as payment. Corporate purchase orders can be used to initiate shipping as well.

Please submit this form to any of the following addresses:

Email:  info@netcharts.com       Mail:  NetFactory, Inc.
					33 Wilelinor Drive
  FAX:  410-266-3656                    Edgewater, MD  21037

	 ** THANK YOU FOR CHOOSING NETCHARTS **