ORDER FORM *** ITGraph(tm) by INDRA Technology, Inc.

THANK YOU FOR PURCHASING THE ITGraph(tm) VBX.  
PLEASE PROVIDE ALL INFORMATION REQUESTED BELOW.

ITGraph VBX..........................$49.95
Shipping & Handling:
	Rush (2 Day) ......$10.00
	1st Class Mail......$5.00    _______ (Enter Preference)
Sales Tax (CA Residents Only)........ $3.50
			  TOTAL......_______
	
ENTER SHIPPING ADDESS BELOW:
	NAME:___________________________________________________
	ADDRESS:________________________________________________
		________________________________________________
	CITY:________________________  STATE:____ ZIP:__________

PLEASE PROVIDE A DAYTIME TELEPHONE NUMBER (WITH AREA CODE):
	PHONE:(_____)_________________ Ext__________

PAYMENT METHOD (Please Indicate Choice):
	[ ]CREDIT CARD (Check One):
		[ ]AMERICAN EXPRESS	[ ]VISA
		CARDHOLDER*:_____________________________________
		CARD NUMBER:_____________________________________
		EXPIRATION DATE:_______________
		*Please copy exactly as appears on credit card.
	[ ]CHECK**
	[ ]MONEY ORDER**
		**Please make payable to Indra Technology, Inc.

FAX TO: (619) 558-1760
OR MAIL TO:
	Indra Technology, Inc.
	8380 Miramar Mall, Suite 222
	San Diego, CA 92121
	Attn: ITGraph

THANKS AGAIN FOR YOUR ORDER!

*** For phone orders or questions, call (800) 735-7776 ***