Order form for NewWorld3D

Fax to: (619) 581-6949

Shipping method:

____ Electronic delivery     ____ Express Mail ($3.50)

____ Other, please specify __________________________

Information:

Name__________________________________________

Address________________________________________

City__________________ State____ Zip___________

Phone _________________________

Email (required for electronic delivery)__________________

Billing information:

Method of payment: ____Visa ____Mastercard ___ Amex

Card number: ____________________________________

Expiration: ________________________________

Signature: __________________________

Optional information:

Where did you here of us: ___ Web search ____Usenet

____ VBxtras ____Other ______________

What type of machine will you be developing with:

__________________________________________

What types of applications will you be developing with NewWorld3D:

___________________________________________

___________________________________________

Thank you for your order!