Beam 2D   ORDER FORM

 Item 1:.....................................................................      Quantity..................

 Item 2:.....................................................................      Quantity..................

 Item 3:.....................................................................      Quantity..................

 Name...................................................................................................................

 Company..............................................................................................................

 ..........................................................................................................................

 Address..............................................................................................................

 ..........................................................................................................................

 City...............................   Province..........   Postal Code.................................

 Telephone...........................................................................................................

 Fax.....................................................................................................................

 E-mail................................................................................................................

 Beam II serial number (required for upgrade) .............................................. 

 Cheque enclosed __        Visa __    Master Card __    Amex __

    P.O enclosed __        Card Number.............................................................

                           Expiry Date.............................................................

  Amount.................         Signature.......................     Date..................................