SciTech Display Doctor 6.53
                                Order Form

SciTech Software, Inc.                                           __/___/___
505 Wall Street                                                  MM /DD /YY
Chico, CA 95928 USA
Toll free: 800-486-4823         Phone: 530-894-8400       Fax: 530-894-9069
                  sales@scitechsoft.com  www.scitechsoft.com

PLEASE PRINT CLEARLY OR TYPE!

Name: _____________________________________________________________________

Company: __________________________________________________________________

Address: __________________________________________________________________

City: __________________________________  State: __________________________

Zip/Postal Code: _______________________  Country: ________________________

Phone: _________________________________  Fax: ____________________________

Email(required for orders placed via email):_______________________________

Register product(s) to: [ ] Company     [ ] Individual

Pay By:  [ ]Check*(USA only)**   [ ]Money Order(US Funds)**  [ ]Credit Card
                  *$15.00 charge for all returned checks
                  **Orders cannot be processed until payment is received

    Credit Card Orders: MasterCard / Visa / Amex / Discover (Circle one)

    Card Number ______________________________________   Expires ____/____

    Cardholder's name (print) ____________________________________________

                 Item                             Cost      Qty     Price
-------------------------------------------     --------    ---     ------
DOS and Windows Installations
SciTech Display Doctor 6.53 w/Disks & Manual    US$44.95    ___   $ ______

SciTech Display Doctor 6.53 Upgrade
     Visit the SciTech Web page (www.scitechsoft.com/down_up.html) 
     for more information.

     Subtotal                                                     $ ______
     California residents ONLY add sales tax      7.25%           $ ______
     Shipping & Handling Charges              US: $9.95                        
                                            Intl: $14.95          $ ______

     Total Enclosed                                               $ ______

  I have read and agree to abide by the enclosed license agreement and I 
  agree to be bound by my credit card agreement. If shipping charges have 
  changed, I agree to pay the new charge.

      (Signature required) _____________________________________
           Shipping charges are `subject to change without notice