-------------------------------------------------------------------------
Micronex®- MinIdent-Win Mail-in Upgrade Purchase Order Form
-------------------------------------------------------------------------

Thank you for your interest in MinIdent-Win. Please complete this form in
CAPITALS. It will constitute your purchase order for the latest upgrade
to your MinIdent-Win software.

Name of purchaser (the "licensee")_______________________________________
Address of purchaser:____________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Phone number of purchaser________________________________________________
Fax number of purchaser__________________________________________________
Email address of purchaser_______________________________________________

Address for delivery if different from above:____________________________
_________________________________________________________________________
_________________________________________________________________________
Name of end-user if different from purchaser:____________________________
Phone number of end-user_________________________________________________
Fax number of end-user___________________________________________________
Email address of end-user________________________________________________

The product code for the installation is:________________________________
The computer code for the installation is: ______________________________
The registration code for the installation is: __________________________

(Note: the codes can be seen by clicking on "About MinIdent-Win" or by
reading them from the file "MIWCODES.txt" which is to be found in the
root directory of the C hard drive).

Please supply us/me with: the key code for the upgrade of my MinIdent-Win
software. The quotation that I received by mail/over the internet,
including all taxes, was for _____________ (US$)

The product code for my software is _____________________________________

Payment in full in United States dollar funds is attached in the form of
(check one):
  [ ] International Money order
  [ ] Western Union Money transfer
  [ ] Certified cheque drawn on any Canadian Bank or Trust Company
  [ ] Please send us information on where to wire payment

For companies with established credit only:
Please supply against our purchase order number:
_________________________________________________________________________

Please note: The code cannot be sent until your payment has been
negotiated and cleared our bank.

Please send your completed order to:
Micronex®, 4356 - 148 Street, Edmonton, Alberta, Canada, T6H 5V5

_________________________
(Dated)

_________________________________________________________________________
(Name and signature of Person requesting the quotation)

-------------------------------------------------------------------------
For Micronex® Use-please do not write in this area