TSM Order Form

To:
VMB RESEARCH
5123 Samson Boulevard
Laval, Quebec
CANADA H7W 2J2


Yes, please rush me one (1) copy of The Sequence Manager 2.98 for
Windows 95/98/NT 4. Price per copy : U.S. $ 19.95 (add 2.95 shipping / handling
[totaling U.S. $ 22.90]):

        Company: ______________________________________________________________

           Name: ______________________________________________________________

        Address: ______________________________________________________________

                 ______________________________________________________________

           City: ______________________________________________________________

 State/Province: ______________________________________________________________

Postal/ZIP Code: ______________________________________________________________

        Country: ______________________________________________________________

          Phone: ______________________________________________________________

            Fax: ______________________________________________________________

      E-Mail #1: ______________________________________________________________

      E-Mail #2: ______________________________________________________________



Payment method (circle one): VISA / MasterCard / Discover / American Express 
                             Cheque / Money Order

Credit card number: ___________________________________________________________

   Expiration date: ___________________________________________________________



Authorization signature: ______________________________________________________