                        VDS Advanced Research Group
                              P.O. Box 9393
                        Baltimore, MD 21228, U.S.A.

                             (410) 247-7117
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                             VDS Order Form

                                                       Date: ___/___/_____
                                                             mm /dd /yyyy

Name: _____________________________________________________________________

Address: Street: __________________________________________________________

     City: ___________________________ State: _____________________________

     Country: _____________________________ Postal/Zip Code: ______________

     * P.O. Box orders are not accepted unless the full payment is enclosed.
       Make checks payable to Tarkan Yetiser. Allow 2-3 weeks for delivery.
       Checks are NOT cashed until the day of shipment.


Phone:  (      )        -                  (      )        -

Contact Person: ___________________________________________________________


Payment Type:            ( ) Enclosed
                         ( ) C.O.D.
                         ( ) Call for arrangement

License Type:  ( ) Personal   ( ) Charity    ( ) Academic   ( ) Business

  * Charity requests must be accompanied by a letter from the organization.

Number of Copies:  ______________


When the programs in the VDS package run, they display the name of the
licensee on the last line of the computer screen. The name can be up to
30 characters in length. Please type in the licensee name you prefer below.
If you leave it blank, we will use the name provided above.


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