                     Product Order Form 

Product     Suggested Retail Price   Special OEM Price 
 
QAPlus 4.7            $159.95             $49.95
         
QAPlus/WIN 5.1        $159.95             $79.95 

QAPlus/fe 5.1         $349.95            $149.95

Power Meter 1.8       $ 99.95            $ 29.95 

QAFloppy 1.6          $299.95            $149.95
         
Price and availability subject to change without notice. 

Please specify desired media when ordering.


                  Please Print or Type 

                     Payment Method: 
  Check ( )   Money Order ( )  VISA ( )  MASTERCARD ( ) 

Company __________________  Check #   ___________________ 

Name    __________________  Card #    ___________________ 

Title   __________________  Expires   ___________________ 

Address __________________  Signature ___________________ 

City    __________________ 

State   ____  ZIP ________

Day Phone (___)-__________

    
    To Order 
       
       Call:    1-800-DIAGSOFT
                        408-438-8247

       FAX:       408-438-7113
    
      Mail:     Diagsoft, Inc. 
                5615 Scotts Valley Dr., Suite 140 
                Scotts Valley,  CA  95066 

