Purchase Agreement

Applicant Information: Please Type or Print Clearly

Last Name: First Name: MI:

Address:

City: State: Zip:

Home Telephone: Business Telephone: Date:

Email Address: Soc. Sec. #--

Choose a Computer:

System 1 -- 233 MHZ MMX Twinhead Desktop Computer w/Monitor --$1,265

System 2 -- 300 MHZ Processor 2-3D Now Twinhead Desktop Computer w/Monitor --$1,615

System 3 -- Laptop 233 MHZ PPMMX Twinhead Slimnote XL --$2,305

System 4 -- Laptop 266 MHZ Intel Mobil Pentium II Twinhead Slimnote XL2-266 --$3,690

OPTIONS: Laptops Only!

For all 2.1 GB Drives, to upgrade to 4.0GB ADD $115
For all 2.1 GB Drives, to upgrade to 6.0GB ADD $305
For all 3.2 GB Drives, to upgrade to 4.0GB ADD $75
For all 3.2 GB Drives, to upgrade to 6.0GB ADD $260
Auto/Airliner Adapter $70
Extra Battery Pack $160
DVD ROM Module* must purchase MPEG II $200
*MPEG II PCMCIA Card $220
AC Adapter $90
Ethernet PCMCIA Cards $63
2 Year Additional Parts and Labor Warranty $180

Totals: System # ___

Wholesale Price: $___________
Options: $___________
Subtotal: $___________
Tax 6 %: $___________
Shipping: $45
Total: $___________

Visa MasterCard Discover

Credit Card # Exp. Date:

Signature_________________________________(required for all credit card orders) Date:

****You must print, sign and fax this document in order for this transaction to be official.****

Fax Number: (704)253-2500