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form_e.txt
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Text File
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1996-07-17
|
4KB
|
111 lines
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| O R D E R - F O R M M S C A N |
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Yes! I would like to order MSCAN. Please send by airmail the latest and
integral version of this program, including the printed manual, to:
Name : ___________________________________________________________________
Address : ___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Country : ___________________________________________________________________
Callsign: _ _ _ _ _ _
(please provide a personalized callsign if you want to use the transmit
option, do not use general calls like 'mscan', 'sstv', 'color' etc.)
Tel: __________________ Fax: __________________ Email: __________________
Send me a.s.a.p. (tick your choice):
[ ] MSCAN 2.10 . . . . . . . . . . . . . . . . . . . . . . fl. 95 (US$ 59)
[ ] MSCAN 2.10 UPGRADE . . . . . . . . . . . . . . . . . . fl. 50 (US$ 31)
(if you already have a registered version of MSCAN)
[ ] Microscan 1.3 (256 colour version) . . . . . . . . . . fl. 50 (US$ 31)
[ ] Microscan RX interface . . . . . . . . . . . . . . . . fl. 75 (US$ 47)
[ ] Miniscan interface . . . . . . . . . . . . . . . . . . fl. 149 (US$ 93)
[ ] Multiscan RX pcb . . . . . . . . . . . . . . . . . . . fl. 39 (US$ 24)
[ ] Multiscan TX pcb . . . . . . . . . . . . . . . . . . . fl. 30 (US$ 19)
(order both for TRX)
[ ] Multiscan RX kit of parts . . . . . . . . . . . . . . fl. 120 (US$ 75)
[ ] Multiscan TX kit of parts . . . . . . . . . . . . . . fl. 75 (US$ 47)
(order both for TRX)
[ ] Aluminum eurocase for kit or pcb . . . . . . . . . . . fl. 39 (US$ 24)
[ ] Multiscan RX assembled . . . . . . . . . . . . . . . . fl. 299 (US$ 187)
[ ] Multiscan TRX assembled . . . . . . . . . . . . . . . fl. 450 (US$ 281)
[ ] Video Blaster SE100 video digitizer . . . . . . . . . fl. 549 (US$ 343)
[ ] Iris high resolution video digitizer . . . . . . . . . fl. 945 (US$ 591)
[ ] SVGA graphics card true colour (VLB or PCI) . . . . . fl. 215 (US$ 134)
[ ] Serial mouse 3-buttons . . . . . . . . . . . . . . . . fl. 39 (US$ 24)
More information about our products is available on request and can be found
on our web site. If you live in Denmark, Hungary or the United Kingdom then
you should order any hardware through your local MSCAN agent (see manual). We
also sell supplies (cables, switch boxes, gender changers etc.) and electronic
parts.
I will pay as follows:
[ ] I have included cash (any currency will do)
[ ] I will pay with a Postal money order (also send us this form!)
[ ] I have included a EUROcheque made out in Dutch guilders (fl.)
[ ] I will pay (+5%) by [ ] Mastercard/Eurocard, [ ] VISA or [ ] JCB
Card number : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Expiry date (good thru): _ _ / _ _
Owner's name : _______________________________________________
Owner's street address : _______________________________________________
Owner's postal/zip code: _______________________________________________
Owner's signature : _______________________________________________
[ ] I have included a cheque (personal or cashiers) and will pay fl. 15.-
(US$ 9) extra for the costs
[ ] I have transferred the amount to [ ] Postbank Arnhem PSTBNL2A nr. 1747205
or [ ] Rabobank Rockanje nr. 35.57.02.606 for CombiTech in Rockanje and
will pay fl. 15.- (US$ 9) extra for the costs (also send us this form!)
All orders are sent via airmail and free of charge!
(E)Mail or fax this form to:
CombiTech,
P.O. Box 507,
3235 ZG Rockanje,
Holland.
Tel/Fax: +31 181 404252
B.B.S. : +31 181 404513
Email : combitech@pi.net
http://www.pi.net/~ctech
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| Thank you for your registration! |
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