Order from:                                              Voice: (702) 735-1980
Ted Gruber Software                                        FAX: (702) 735-4603
PO Box 13408                                               BBS: (702) 796-7134
Las Vegas, NV  89112                                  email: fastgraph@aol.com

Name:    _____________________________________________________________________

Company: _____________________________________________________________________

Address: _____________________________________________________________________

City:    _____________________________________  State: ________  Zip: ________

Country: _________________ Phone: __________________  FAX: ___________________

+=====+=========================================+=======+============+=======+
|     |                                         | Price |  Shipping  |       |
| Qty |            Product Description          | Each  | Code  Cost | Total |
+=====+=========================================+=======+=====+======+=======+
|     | Fastgraph for DOS                       | $249  |  1  |      |       |
+-----+-----------------------------------------+-------+-----+------+-------+
|     | Fastgraph/Fonts for DOS                 |  $69  |  2  |      |       |
+-----+-----------------------------------------+-------+-----+------+-------+
|     | Fastgraph/Image for DOS                 |  $69  |  2  |      |       |
+-----+-----------------------------------------+-------+-----+------+-------+
|     | FG PowerPack for DOS (above 3 products) | $359  |  1  |      |       |
+-----+-----------------------------------------+-------+-----+------+-------+
|     | Fastgraph for Windows                   | $249  |  1  |      |       |
+-----+-----------------------------------------+-------+-----+------+-------+
|     | Fastgraph/Fonts for Windows             |  $69  |  2  |      |       |
+-----+-----------------------------------------+-------+-----+------+-------+
|     | Fastgraph/Image for Windows             |  $69  |  2  |      |       |
+-----+-----------------------------------------+-------+-----+------+-------+
|     | FG PowerPack for Win (above 3 products) | $359  |  1  |      |       |
+-----+-----------------------------------------+-------+-----+------+-------+
|     | Fastgraph for DOS + Windows bundle      | $398  |  1  |      |       |
+-----+-----------------------------------------+-------+-----+------+-------+
|     | FG Double PowerPack (DOS and Windows)   | $598  |  1  |      |       |
+=====+=========================================+=======+=====+======+=======+
                                                           Subtotal  |       |
*********************************                                    +=======+
*                               *     NV/AZ residents add sales tax  |       |
* Shipping charges per product: *                                    +=======+
*                               *     COD orders (U.S. only) add $6  |       |
*     Code 1         Code 2     *                                    +=======+
*   ----------     ----------   *                             Total  |       |
*   U.S.    $7     U.S.    $3   *                                    +=======+
*   Canada $12     Canada  $3   *    Method of payment:
*   Other call     Other   $5   *
*                               *       [ ] payment enclosed
*********************************       [ ] Visa or MasterCard
                                        [ ] COD
                                        [ ] purchase order # _________________
For credit card orders only:

Card number: ____________________________________  Expiration date: __________

Signature:   _________________________________________________________________