Green Mountain Computing Systems, Inc. ORDER FORM P.O. Box 275, 1070 W. Main St., Richmond, VT 05477 Fax: (802) 434-5071 Name _________________________________________________________________ Address ______________________________________________________________ Address ______________________________________________________________ City ______________________________ State ____________________________ Zip Code ____________________ Country ________________________________ E-mail Address _______________________________________________________ Telephone # __________________________________________________________ Item Description Unit Price Quantity Item Total VHDL Studio Windows, SINGLE user US $1595 _______ _________ Linux, SINGLE user US $1595 _______ _________ SUBTOTAL _________ Total Shipping SHIPPING METHOD Unit Price Quantity Total o Standard US $6 _______ _________ o Federal Express Overnight US $12 _______ _________ (Continental U.S. only) TOTAL CHARGES TOTAL _________ PAYMENT METHOD: [ ] Check or Money Order Enclosed [ ] Charge to the following: [ ] Visa [ ] MasterCard Card Number: ___________________________ Expiration: ___/___ Name on Card: ___________________________ Signature: _____________________ Card holder address: _____________________________________________________ (If different) * Prices are subject to change without notice.