===============================================================================
                              O R D E R    F O R M
===============================================================================

First Name ____________________________ Last Name _____________________________

Company    ____________________________________________________________________

Address1   ____________________________________________________________________

Address2   ____________________________________________________________________

City/Town  ____________________________________________________________________

State      _______  Zip Code  ______________  Country _________________________

Day Phone   ____________________________ Fax # ________________________________

Serial # (upgrades from PowerBASIC, TurboBasic, QuickBasic, PDS) ______________

Credit Card; Discover [ ], Master Card [ ], Visa [ ], American Express [ ]

          Card #    _____________________________________________ EX ____/_____

          Signature ___________________________________________________________

Check [ ];  Please remit in U.S. funds drawn on a U.S. Bank.
                                                             Shipping
Quan                 Description                     Price  (USA/ Int)  Total
____ PowerBASIC 3.2 Full Product                    $149.00  $6 / $28  ________
____ Full Upgrade (W/Manuals) from PB 2.x           $ 59.00  $6 / $28  ________
____ Upgrade From TurboBasic, QuickBasic, PDS,      $ 99.00  $6 / $28  ________
          and VBDOS
____ PowerBASIC Developer Kit for Windows           $149.00  $6 / $28  ________
____ PowerBASIC DK Bundle (Both PB 3.2 and PBDK)    $289.00  $10/ $56  ________
____ PB/Xtra II (Programmer's Reference Collection) $ 49.00  $4 / $10  ________
          [__] CDROM      [__] 3.5" Disk
____ PowerBASIC DLL Compiler for Windows            $149.00  $6 / $28  ________
____ QuickPak Professional for DOS                  $129.00  $6 / $28  ________
____ SoftCode for PowerBASIC (Code Generator)       $ 99.00  $6 / $28  ________
____ SoftDemo and Flash-up Toolbox                  $ 49.00  $4 / $10  ________

                 All upgrades require a previous serial number.
Sub-Total                                                              ________

Priority Shipping (USA Only)
        [__] Overnight add $16.00, [__] Second Day add $6.00           ________
                                                                                   [__] COD's (USA Only) Add $5.00         _________
               Sales Tax (California Residents Only) @ 7.25%           ________

Total                                                                  ________
                                                                                                                                         Total _________
           PowerBASIC, Inc., 316 Mid Valley Center, Carmel, CA 93923
         408-659-8000 voice, 408-659-8008 fax, 800-780-7707 orders only
              75300,1742 CompuServe, sales@powerbasic.com Internet
