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Text File  |  1995-09-01  |  3KB  |  51 lines
  1.                          My Little Realm Enterprises Order Form
  2.  
  3.           Last: ___________________________  First: ________________  M.I. __
  4.  
  5.           Address: __________________________________________________________
  6.  
  7.           City: _________________________________________  State: ___________
  8.  
  9.           Zip: ________________ Home Phone: (________) ______________________
  10.           ___________________________________________________________________
  11.  
  12.           ____  I want to purchase the programs checked below:
  13.  
  14.                 ____  Calling Cards              ____  Public Library
  15.                 ____  Charge Card                ____  Read More
  16.                 ____  Checking                   ____  Records of the Realm
  17.                 ____  Private Library            ____  Savings
  18.  
  19.           Number of programs purchased _____ at $20 each          _________
  20.                                               Shipping/Handling   ___$5.00_
  21.           ___________________________________________________________________
  22.  
  23.           ____  I'd rather save $125!  Rush me MLR/the System for only $35.
  24.  
  25.           My Little Realm/The System   _______   at  $35/system   _________
  26.                                               Shipping/Handling   __$10.00_
  27.           ___________________________________________________________________
  28.  
  29.                                                        Subtotal   _________
  30.                       New Jersey residents please add sales tax   _________
  31.  
  32.                                        Total amount of purchase   _________
  33.           ___________________________________________________________________
  34.  
  35.           Bonus program:  ________________________    [Limit one per order.]
  36.           ___________________________________________________________________
  37.  
  38.           Disk Info   --    Disk size:   ___ 5 1/4"   ___ 3 1/2" (default)
  39.                               Density:   ___ DS/DD    ___ DS/HD (default)
  40.           ___________________________________________________________________
  41.  
  42.           Please send your check or money order to:  
  43.  
  44.                               My Little Realm Enterprises
  45.                               22 Church Street #103, Suite 376
  46.                               Ramsey, New Jersey 07446
  47.  
  48.           Checks and money orders must be drawn on U.S. banks in U.S. funds.
  49.           Credit card and phone orders cannot be accepted.   [19950901:v3.3]
  50.           ___________________________________________________________________
  51.