home *** CD-ROM | disk | FTP | other *** search
/ DP Tool Club 22 / CD_ASCQ_22_0695.iso / win / prg / hyprvb12 / order.txt < prev    next >
Text File  |  1995-03-31  |  2KB  |  52 lines
  1. HyperVB ORDER FORM
  2. You may also register HyperVB via Compuserve (GO SWREG, ID# 5201)
  3.  
  4. Name_______________________________________________________________
  5.  
  6. Company____________________________________________________________
  7.  
  8. Street_____________________________________________________________
  9.  
  10. City___________________________________ State/Prov_________________
  11.  
  12. Country____________________________ZIP/Code________________________
  13.  
  14. Telephone _________________________ FAX  __________________________
  15.  
  16. E-Mail/CIS Address__________________________
  17.  
  18.  
  19. I would like (check one):  5 1/4"   _____  disk
  20.                            3 1/2"   _____  disk
  21.                            CIS-Mail _____
  22. -----------------------------------------------------------------------------
  23. HyperVB and developer's license        $69.95 US x ____     $_______
  24.  
  25. Additional developer's licenses        $37.95 US x ____      $_______
  26.  
  27. Michigan Residents: Add 6.0% sales tax                      $_______
  28.  
  29. Shipping & Handling    (see below)                  $_______
  30. -----------------------------------------------------------------------------
  31.                             Total:    $_______US
  32.  
  33. Shipping Information
  34. US Mail:            $5.00.
  35. International:             $9.00.
  36.  
  37. CIS Mail:            No charge.  File will be sent "Receiver Pays".
  38.                 CIS will charge you directly for any surcharge.
  39.                 Mail product payment separately to Data Preference.
  40.  
  41. Payment may be made by:
  42.         US: Check or Money Order
  43.         CompuServe: GO SWREG ID#5201
  44.         International:  Check drawn on U.S. bank; Wire transfer
  45.  
  46. Make payment to:
  47. Data Preference
  48. 27226 Lawrence Drive
  49. Dearborn Heights, MI 48127
  50. Tel: (313) 278-4187  (8:00 AM to 6:00 PM EST)
  51. CIS#: 70162,1037
  52.