(minimum order of 10 licenses for the NExS Enterprise Edition)

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           ONLY REQUIRED FOR NExS ENTERPRISE LICENSES!

Host id: _______________     Host name: ___________________________
         (8-digit hex #)
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Name:      _________________________________________

Company:   _________________________________________ (if applicable)

E-mail:    _________________________________________

Telephone: _________________________________________

FAX:       _________________________________________

Street:    _________________________________________
        
           _________________________________________

           _________________________________________

City:      _________________________ State: ______ ZIP: ______________

Country:   _______________________________

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Credit card:   ___MasterCard  ___VISA

Credit card #: ____________________________ Exp. date: ___________

Signature: _______________________________________________________

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Mail to:  GreyTrout Software, Inc. |  FAX to: (919) 387-1302
          4001 Brothwell Ct.       |
          Raleigh NC 27606         |  Order by phone: (800) 549-9377 (USA)
          USA                      |                  (919) 387-0076 (Int'l)