home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
DP Tool Club 19
/
CD_ASCQ_19_010295.iso
/
vrac
/
wcspel.zip
/
ORDER.FRM
< prev
next >
Wrap
Text File
|
1994-10-02
|
1KB
|
43 lines
Ship To:
Name: ______________________________________
Address: ______________________________________
City: ______________________________________
State: ______________________________________
Zip: ______________________________________
Email Address:______________________________________
Phone Number: ______________________________________
Registered Version delivered via email - $11.95
Registered Version delivered via conventional mail - $14.50.
# of copies @ $11.95 ________ for a total of ________
# of copies @ $14.50 ________ for a total of ________
Shipping & Handling (USA $0.00 All Others $1.25) ________
VA residents add 3.5% ________
Total Amount Due ________
Include Check/Money order or complete the following:
Visa/Mcard ____ Amex ____ Card Number: _____________________
Expiration Date _____
I agree to pay above total amount according to card issuer agreement.
Signed _____________________
Thank you for your order!
Comments: