ORDER FORM

 Name: ______________________________________________

 Company: ___________________________________________

 Address: ___________________________________________

 City: ______________________________ State: ________

 Zip code: _____________________

 Phone: _____________________________  Ext: _________

 Product                          Quanity          Price/each       Total
------------------------------------------------------------------------------

 MSECURE Server Version          _______      x       $195    =    _________
 The Secure Screen Saver

 6 months FREE upgrades included
 Site licensing is also available. Call for details.

                                        ---------------------------------------
                  [2-day Express Mail]   Shipping and Handling ($5)
                                         (Fed Ex available for $15)
                                         (COD Charge add $10)       _________
	
                                         Tax (VA residents add %4): _________


                                         Total order:               _________

                          [All orders shipped on 3-1/2"]

How do you wish to pay for your order:

       Purchase Order _______        Check _________        COD _____________

       Visa __________   Account Number:  ___________________________________

                         Expiration Date: _________________

Additional information:

        What version Netware are you running? ______________

Please return form to:

        Dana Consultants
        PO Box 2953                            (800) 800-9301
        Reston, VA 22091