SciTech Display Doctor 5.3a
                            Order/Registration Form

    SciTech Software, Inc.					___/___/___
    505 Wall Street,						MM /DD /YY
    Chico, CA 95928 USA
    Toll free: 800-486-4823     Phone: 916-894-8400       Fax: 916-894-9069

PLEASE PRINT CLEARLY OR TYPE!

    Name: _________________________________________________________________

    Company: ______________________________________________________________

    Address: ______________________________________________________________

    City: ________________________________  State: ________________________

    Zip/Postal Code: _____________________  Country: ______________________

    Phone: _______________________________  Fax: __________________________

    Email(required for email orders):______________________________________

    Register product(s) to: [ ] Company     [ ] Individual

    Pay By:   [ ] Check (USA only)  [ ] Money Order  [ ] Credit Card
                   *$15.00 charge for all returned checks

    Credit Card Orders: MasterCard / Visa / Amex / Discover (Circle one)

    Card Number ______________________________________   Expires ____/____

    Cardholder's name (print) ____________________________________________

                 Item                               Cost      Qty   Price
-------------------------------------------       --------    ---   ------
Windows/DOS (Windows based install)
  SciTech Display Doctor 5.3a w/Disk              US$34.95    ___ $ ______
  SciTech Display Doctor 5.3a w/Disk & Manual 	  US$44.95    ___ $ ______

DOS Only (DOS based install)
  SciTech Display Doctor 5.3a w/Disk              US$34.95    ___ $ ______
  SciTech Display Doctor 5.3a w/Disk & Manual 	  US$44.95    ___ $ ______

     Subtotal                                                     $ ______
     California residents ONLY add 7.25% sales tax                $ ______
     Shipping & Handling Charges                                  $ ______
           US: Disk $5.00         Disk and Manual $7.50	
         Intl: Disk $7.50	  Disk and Manual $15.00
         For Australia see AUSORDR.WRI
     Total Enclosed                                               $ ______

  I have read and agree to abide by the enclosed license agreement and I 
  agree to be bound by my credit card agreement. If shipping charges have 
  changed, I agree to pay the new charge.

      (Signature required) _____________________________________
          Shipping charges are subject to change without notice