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                         Rice University
          Computer and Information Technology Institute

                       Software Order Form

                     (This file:  ORDER)
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Licensee's full legal name:  ____________________________________

Complete mailing address:  ______________________________________

Shipping address:           _____________________________________
(if different from above)

Licensee contact person:   ______________________________________
     Telephone:   ________________________   
     FAX number:  ________________________
     Email:       ________________________


Complete CITI catalog number
of software to be sent:  _____________________________________

Catalog title of software: ______________________________________
Note: See description of requirements in catalogue.

Delivery:  Email?       _____      Email address:  ______________

           Tape (QIC-150 format only)?   _____

License fee (from catalog)                        U.S. $ ________
 (includes Email or ground shipping)

Overnight courier add $15.00
  (U.S./Canada destinations only)                      $ ________


Total amount enclosed:                            U.S. $ ________

Please mail signed agreement to:

                     Rice University
                     CITI/SDC
                     P.O. Box 1892
                     Houston, TX  77251-1892
                     713-527-6077



          ACCEPTED AND AGREED TO:

                        _________________________________________
                        Name of Requesting Organization


                        By ______________________________________
                        Signature of authorized representative of
                        your organization  

			_________________________________________
                        Name (typed or printed)

                        _________________________________________
                        Title

                        ________________________________________
                        Date


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                         CITI Use Only:

Date received:  __________________________

Date shipped:   __________________________

Version date of 
  printed license
  shipped with software: _________________

Remarks:        __________________________________________



CITI staff initials:  ______          Date: _______