Please print this form and follow the instructions below:
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                          DDH Software Order Form
                        Email, Mail, Fax, or Phone to:

                               [DDH Software]
                            ATTN: David Haupert
                               PO Box 970971
                          Boca Raton, Fl 33497-0971
                               (561) 470-2133
                         email: sales@ddhsoftware.com
                        web: http://www.ddhsoftware.com
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First Name:____________________      Last Name:____________________________

Street: _____________________________________________________________

City:________________________________________________________________

State:____________________ Zip Code:___________ Country:_____________

Day Phone: _______________________  Eve Phone:_______________________

Email address:_____________________________________________

Choose Payment Option:
[ ] *Check or *Money Order (enclosed)  [ ] First Virtual  [ ] Credit Card
* Please make payable to: David Haupert

Choose one shipping option:  [ ] Via Email      [ ] Via Mail (*US Only)
                                                             (*PC Only)
If Registering by First Virtual: Pin #: __________________________________

By Credit Card: Check one: [ ] Visa  [ ] MasterCard   [ ] American Express

Account Holder full name (as it appears on card): _________________________

Credit Card Account #:  ___________________________________________________

Expiration Date (MM/YY): ___/___

Product(s): Enter the Quantity of each item you would like to register:
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Quantity Description                     # Words      Price (US $)   Total
____     Translate + Danish Language     3787/4062        $12.00     $
____     Translate + Dutch Language      8633/19109       $12.00     $
____     Translate + Esperanto Language  8665             $12.00     $
____     Translate + Finnish Language    3228             $12.00     $
____     Translate + French Language     7135/9055/12341  $12.00     $
____     Translate + German Language     9335/17140       $12.00     $
____     Translate + Hungarian Language  1200             $12.00     $
____     Translate + Icelandic Language  1106/1274        $12.00     $
____     Translate + Indonesian Language 1155             $12.00     $
____     Translate + Italian Language    2275/3526/4504   $12.00     $
____     Translate + Japanese Language   1806/9752/2577*  $12.00     $
         *Shipped with free larger EDICT_S database
____     Translate + Latin Language      745/1739         $12.00     $
____     Translate + Mandarin Language   1491/1834        $12.00     $
____     Translate + Norwegian Language  1936             $12.00     $
____     Translate + Portuguese Language 2353/3338        $12.00     $
____     Translate + Spanish Language    3666/8083/11663  $12.00     $
____     Hangman + Wheel of Treasure     N/A              $12.00     $
____     Thesaurus                       52,255           $15.00     $
____     HanDBase                        N/A              $19.99     $
____     HanDBase Manual                 N/A              $ 3.00     $
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                                                Subtotal             $
                                                Less any Discount  - $
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                                                Total amount         $

I authorize David Haupert to charge the appropriate amount as noted above
for providing the appropriate software as listed above.  Software will be
shipped or emailed as noted above.  I understand that the software is
released as shareware and it is protected by copyright from illegal use
and/or copying.  I also understand that the software is released as is, and
that author is not responsible for any damages that may occur from the use
or misuse of this software.

Signature:_________________________________________ Date:______________
