************************************************************************ * * * Car Restoration Diary - Version 2.31 * * Copyright (c) 1993 by BlueCollar Software * * * * Published exclusively by: * * RMH Computer Services * * PO Box 657 * * Beech Grove IN 46107-0657 * * (317) 782-9903 * * * ************************************************************************ ORDER FORM ---------- Send registration form and payment to: Richard Holler RMH Computer Services PO Box 657 Beech Grove IN 46107-0657 USA -------------------------------------------------------------------------- I have enclosed ..(U.S. Dollars)............. ___ $29.00 Others send International Money Order, US Funds, please. Indiana residents please add 5% State sales tax.. $_____ Overseas residents please add $5.00 S/H ....... $_____ Total $_____ PLEASE PRINT Name...: __________________________________________________________ Address: __________________________________________________________ : __________________________________________________________ : __________________________________________________________ Phone..: ______________________ Sales Code: CRD231JCSM Email Address (if available): _____________________________________ I would like to receive: ____ 5-1/4" disks ____ 3-1/2" disks. I received this program from: _____________________________________ _____________________________________ _____________________________________ CREDIT CARD ORDERS ------------------ For fast Credit Card (MC/VISA/DISCOVER) ordering, please call us at 317-782-9903. Or, you can provide the information (including your signature!) in the space below. *ALL* spaced must be completed: +------------------------------------------------------------------+ | We can accept MasterCard, Visa, and Discover credit cards. | | | | MasterCard [_] Visa [_] Discover [_] | | | | Credit Card Number: ________ ________ ________ ________ | | | | Name on the Card: _____________________________________________ | | | | Expires: _______ Signature (*)________________________________ | +------------------------------------------------------------------+ (*) NOTE: This *REQUIRES* a hand-written signature!