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Text File  |  1993-08-22  |  3KB  |  50 lines
  1.                                                             Payment Method:
  2. Mail to:                    O R D E R   F O R M                      
  3. ========                    = = = = =   = = = =              Cash  [  ]
  4.                                                             Draft  [  ]
  5.                                                              Wire  [  ]
  6. Xbase Network System                                          COD  [  ]
  7. 5337 College Avenue #451                              Money Order  [  ]
  8. Oakland, CA 94618                                   Cashier Check  [  ]
  9. BBS: 510/687-3633                                  Personal Check  [  ]
  10.  
  11. First Name    : ___________________        LastName : ________________ 
  12.  
  13. Board Name    : ______________________________________________________
  14. Address       : _______________________________
  15.                 _______________________________
  16.                 _______________________________
  17. BBS Number    : _______________________________
  18. Telephone     : _______________________________
  19.  
  20. Diskette Type   : [ ]  5-1/4 High Density      [ ]  3-1/2 High Density
  21. Platform to use :  [ ] DOS Single-user   [ ] Novell   [ ]  Concurrent DOS
  22. [  ] Unix/Xenix    [ ] VM-386   [ ] PC-MOS  [ ] Windows  [ ] DesqView
  23.  
  24. Item Qty  Part Number   Description                             Amount
  25. ==== ===  ===========   ===================================     =========
  26. 1    ___  ___________   ___________________________________     _________
  27.  
  28. 2    ___  ___________   ___________________________________     _________
  29.  
  30. 3    ___  ___________   ___________________________________     _________
  31.  
  32. 4    ___  ___________   ___________________________________     _________
  33.                           All California Orders are subject
  34.                                                to 8.25% tax     _________
  35. NOTE : All orders must          
  36. be pre-paid.                                Shipping Charge      $ 5.00    
  37. Personal checks takes            
  38. 2-4 weeks before actual   (A $10.00 extra charge for  C.O.D     _________
  39. shipment. A $20.00 Fee    (COD handling Fee)                
  40. for all bounced checks                      
  41. are imposed plus bank     TOTAL CHARGES      :      $______________
  42. Fees.   No Refunds for    
  43. software purchases.       PAYMENT            :      $______________
  44.                      
  45.                           BALANCE            :      $______________
  46.  
  47. _______________________       __________________________
  48. Customer Signature            TAX ID, only if Tax Exempt
  49. Certifies Acceptance
  50.