430 Laird Road, Suites 5-7, Guelph, Ontario, Canada  N1G 3X7
PHONE 1-888-OSI-TECH FAX (519) 836-6156 EMAIL sales@ositech.com
Ositech Test Drive Program
Ositech offers you an opportunity to purchase up to 2 of each of Ositech's PC Card 
products at a reduced price to conduct field trials. 


Some Quick Questions 

1. What is your job title: ________________________

2. How many notebooks do you have at your company location? _________


3. Are you considering purchasing PC Cards in the next 90 days?  Yes  or   No   ____

4. How many cards are you considering purchasing in the next 90 days?     ________

5. What type of PC Cards do you use?  

      _______________________________________________

Continued

6. Have you heard of Ositech previously?   Yes  /   No

7. What is your notebook Operating System? ________________________________________

8. What magazines do you read? 
__________________     ___________________

__________________     ___________________


9. What are the 4 most important factors when you choose a PCMCIA card solution?
__________________     ___________________

__________________     ___________________

Description:
Product Name:			Quantity:	Cost:		Shipping Charges:












Shipping This unit will be shipped UPS Ground unless otherwise indicated. Please allow 2 - 4 weeks for processing and shipping.  Ositech will contact you with the correct shipping charges for your quantity.
Other Shipping Instruction(s)/Method(s):______________________________________________________
 Ship To:
Name: _______________________Date:_________
Company:__________________________________
Address:____________________________________
City:_______________ State:______ Zip:_________
Phone. #_______________ Fax #_______________
e-mail:______________________________
Credit Card Information:  
O Visa           
Card Holder's Full Name (please print): _______________________________________________
Credit Card #:__________________________________
Exp. Date: _______________
Authorizing Signature: ____________________________________________

Notes/Comments: __________________________________________________________________
Document Revision: 9/1/98 
Please complete and fax back to Ositech (519) 836-0593