Pilot3D     ^{"3D For All"}

Order Form

1. Version = __________________________ ..............  ________

2. Sales Tax for RI, MA, CT (US only)

    Rhode Island (7%)  ...............................  ________

    Massachusetts (5%)  ..............................  ________

    Connecticut (6%)  ................................  ________

3. Shipping/Handling (US $5, Elsewhere $10 CD only) ..  ________

Name _______________________________________________

Company ____________________________________________

Address1 ___________________________________________

Address2 ___________________________________________

City _______________________________________________

State/Province _____________________________________

Country ____________________________________________

Zip/Postal Code ____________________________________

Tel/Fax/E-Mail _____________________________________

VISA/MC Number _____________________________________

Expiration Date ____________________________________

Name on Card _______________________________________

Signature __________________________________________