WUSAGE KEY ORDER FORM

Please fill out this form completely.  ** Missing information may delay your
receipt of your key to unlock Wusage! **  Tell your purchasing department
that WE NEED THIS FORM and your e-mail address to send you a key!  Mail to:

Boutell.Com, Inc.
P.O. Box 63767
Philadelphia PA 19147, USA

Copies Ordered:    ______    Total Enclosed:    $ ______
1 Domain license 	$  25 (1 virtual domain)
5 Domain license 	$  75 (5 virtual domains)
ISP/site license	$ 295 (many domains in one location)
global license 		$1995 (company wide license with source code)

Educational and non-governmental nonprofit pricing is one-third of
the prices quoted above, minimum $25.  Contact Boutell.Com for volume pricing.

Checks must be in U.S. funds drawn on a U.S. bank. Credit card orders
may be faxed to (208) 445-0327, or phoned to (215) 574-7655.
International bank transfers: you must call us first!

Your Status: ___ Nonprofit(*) ___ Educational(*)  ___ All Others

(*) Non-governmental nonprofit and educational institutions MUST PROVIDE 
EVIDENCE of their non-commercial status.  Evidence can be I.R.S. documentation; 
this form or a note printed on school letterhead; or a copy of the 
organization's brochure clearly indicating non-profit status.  FAILURE TO 
INCLUDE THIS INFORMATION MAY DELAY YOUR ORDER.  Individuals do not qualify as 
educational or nonprofit institutions.  If you have a question, call us at 
(215) 574-7655.

Payment Method:  ___ Check ___ Money Order ___ Credit Card ___ Purchase Order
                                                               PO#: _________
Credit Card:     ___ Discover  ___ Visa   ___ Mastercard ___ American Express

   If you are paying by credit card, we must have the following information:

   Credit Card Number: ______ ______ ______ ______ Expiration Date: ____/____

   Name as it Appears on the Card:    ___________________

   Cardholder's Signature:            ___________________ 

Your key will be sent to (please type or print CLEARLY):

E-mail Address (Important!):   _________________________

Name:                    _______________________________

Organization (Optional): _______________________________

Complete Street Address: _______________________________

                         _______________________________

                         _______________________________

                         _______________________________

Country:                 _______________________________

You will receive your key to unlock the software via e-mail.  You will also 
receive a receipt via postal mail.  Thank you for your business!