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Text File  |  1994-04-17  |  6KB  |  91 lines
  1. ■ If you wish to order by credit card or via BBS then 
  2.   please refer to the file CREDIT.FRM, instead of this one.
  3.  
  4.   If you use this form- send it by mail to:
  5.   Megalomania Software
  6.   779 Cathcart Blvd
  7.   Sarnia, Ontario CAN
  8.   N7V 2N6
  9.  
  10. ■ Please make sure all Cheques and/or Money Orders are made out
  11.   to: Jason Percival - If this form is used.
  12.  
  13.                        ┌───────────────────────────┐
  14.                        │   Megalomania Software    │▐
  15.                        │     779 Cathcart Blvd     │▐
  16.                        │      Sarnia, Ontario      │▐
  17.                        │          N7V 2N6          │▐
  18.                        │    (519) 332-0638 Data    │▐
  19.                        └───────────────────────────┘▐
  20.                          ▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀
  21.  
  22. ┌─[ INSTRUCTIONS ]─────────────────────────────────────────────────────────┐
  23. │ ■ Please complete this form in its entirety from top to bottom.          │
  24. └──────────────────────────────────────────────────────────────────────────┘
  25.  
  26. ┌─[ PERSONAL INFORMATION ]─────────────────────────────────────────────────┐
  27. │                                                                          │
  28. │ Company Name___________________________________________________________  │
  29. │             (If not a company, use name of BBS)                          │
  30. │                                                                          │
  31. │ BBS Name_______________________________________________________________  │
  32. │         (If different from "Company Name")                               │
  33. │                                                                          │
  34. │ Contact________________________________________________________________  │
  35. │        (Use your real name: FIRST LAST, i.e. JOHN DOE)                   │
  36. │                                                                          │
  37. │ Title____________________________________ or [_] System Operator (SysOp) │
  38. │                                                                          │
  39. │ Voice Phone (_____)_____-______          Data Phone (_____)_____-______  │
  40. │                                                                          │
  41. │   Fax Phone (_____)_____-______        Data Phone 2 (_____)_____-______  │
  42. │                                                                          │
  43. │ Street_________________________________________________________________  │
  44. │                                                                          │
  45. │ Suite/PO Box/Apt/Rt/MS_________________________________________________  │
  46. │                                                                          │
  47. │ City____________________________ State/Province________________________  │
  48. │                                                                          │
  49. │ Postal Code_______________ Country: [_]USA [_]CANADA [_]OTHER__________  │
  50. │                                                                          │
  51. │ Referred By: [_]Hamilton TeleGraphics   [_]Friend  [_]Sysop              │
  52. │              [_]Boardwatch      [_]ComputorEdge    [_]Other_____________ │
  53. └──────────────────────────────────────────────────────────────────────────┘
  54.  
  55. ┌─[ NETWORK INFORMATION ]──────────────────────────────────────────────────┐
  56. │                                                                          │
  57. │ Fidonet____:______/_________ Internet Address___________________________ │
  58. │                                                                          │
  59. │ CompuServe________,_________ America On-line____________________________ │
  60. │                                                                          │
  61. │ Other 1_____________________________ Other 2____________________________ │
  62. └──────────────────────────────────────────────────────────────────────────┘
  63.  
  64.  
  65. ┌─[ ORDER PAYMENT INFORMATION ]────────────────────────────────────────────┐
  66. │                           Select Form of Payment                         │
  67. │                                                                          │
  68. │      [_]Check Enclosed°       [_]Money Order Enclosed                    │
  69. │                                                                          │
  70. │      °If paying by check, please allow up to 5 business days for your    │
  71. │       check to clear.  To expedite process, pay by money order.          │
  72. │                                                                          │
  73. │ Signature (If this form is sent by mail)________________________________ │
  74. └──────────────────────────────────────────────────────────────────────────┘
  75.  
  76. ┌─[ ITEMS WHICH INCLUDE S&H ]────────────────────┬───┬───┬────┬────────────┐
  77. │                                                │   │   │    │            │
  78. │ ITEM                                           │VER│   │COST│ QTY  TOTAL │
  79. │                                                │   │   │    │            │
  80. │ PCX2ICO - PCX Converter for RoboBOARD/FX       │1.3│   │$ 15│ ___  _____ │
  81. │ ICON/FX - 256 Color Icon Editor for Robo/FX    │1.0│   │$ 20│ ___  _____ │
  82. │                                                └───┘   └────┘            │
  83. ├─[ TOTALS / TAX ]─────────────────────────────────────────────────────────┤
  84. │                                                                          │
  85. │                                                             TOTAL _____  │
  86. └──────────────────────────────────────────────────────────────────────────┘
  87.  All sales are final - please evaluate Shareware products prior to purchase
  88.  
  89.                            Thank you for your order!
  90.  
  91.