VISITT 3.0 ORDER FORM AND REGISTRATION

To order the VISITT 3.0 diskettes and user manual, and to become a registered user, please complete this order and registration form and
mail or fax it to the location indicated below.  VISITT 3.0 is available at NO
CHARGE.


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   U.S. EPA Vendor Information System for Innovative Treatment Technologies
              (VISITT) Version 3.0 Order and Registration Form


Mail to:  U.S. EPA/NCEPI	       Fax to:  U.S. EPA/NCEPI
	  P.O. Box 42419          OR            (513) 891-6685
	  Cincinnati, OH  45242-0419            (513) 891-6561 (Verification)



Please type or print legibly.  Allow 3-4 weeks for delivery.


Name _________________________________________________________________________


Company/Agency _______________________________________________________________


Street _______________________________________________________________________


City __________________________ State _________________ Zip Code _____________


Country _______________________ Telephone Number _____________________________


Date Ordered ____________________________


	_____   Register me as a VISITT user.


   	_____	Send me VISITT 3.0 diskettes and a user manual.

   		 Diskette Size (check one)	3 1/2" _____  5 1/4" _____


        _____	Send me a VISITT 3.0 User Manual ONLY.


        _____	I am an innovative treatment technology vendor and would like
		to receive an application to be included in VISITT 4.0.  Place
		me on the VISITT 4.0 Application Mailing List.


        _____	I am an innovative measurement or monitoring technology
		vendor and would like to receive an application for the new
		measurement and monitoring vendor database.  Place me on the
		Measurement/Monitoring Database Application Mailing List.