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order.txt
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1993-01-18
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ORDER FORM
Name: ______________________________________________
Company: ___________________________________________
Address: ___________________________________________
City: ______________________________ State: ________
Zip code: _____________________
Phone: _____________________________ Ext: _________
Product Quanity Price/each Total
------------------------------------------------------------------------------
MSECURE Server Version _______ x $195 = _________
The Secure Screen Saver
6 months FREE upgrades included
Site licensing is also available. Call for details.
---------------------------------------
[2-day Express Mail] Shipping and Handling ($5)
(Fed Ex available for $15)
(COD Charge add $10) _________
Tax (VA residents add %4): _________
Total order: _________
[All orders shipped on 3-1/2"]
How do you wish to pay for your order:
Purchase Order _______ Check _________ COD _____________
Visa __________ Account Number: ___________________________________
Expiration Date: _________________
Additional information:
What version Netware are you running? ______________
Please return form to:
Dana Consultants
PO Box 2953 (800) 800-9301
Reston, VA 22091