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Text File  |  1994-01-15  |  2KB  |  63 lines
  1.                           QUIKCOPY ORDER FORM
  2.  
  3.  
  4. Name: _________________________________________________________________
  5.  
  6.  
  7. Address: ______________________________________________________________
  8.  
  9.  
  10.          ______________________________________________________________
  11.  
  12.  
  13.          ______________________________________________________________
  14.  
  15.  
  16.          ______________________________________________________________
  17.  
  18.  
  19. Email Address (if any): _______________________________________________
  20.  
  21.  
  22. Serial Number (if upgrading): _________________________________________
  23.  
  24.  
  25. Please state current version that you have: ___________________________
  26.  
  27.  
  28. Signature: ____________________________________________________________
  29.  
  30.  
  31. Telephone (optional): _________________________________________________
  32.  
  33.  
  34. FAX Number (optional): ________________________________________________
  35.  
  36.  
  37. Form of payment: VISA/MASTERCARD __ Card number: ______________________
  38.  
  39.  
  40.                  CHEQUE _____ POSTAL ORDER _____ OTHER ________________
  41.  
  42.  
  43. Payment inside South Africa: _____________ x R25 = ____________________
  44.  
  45.  
  46. Payment outside South Africa: ____________ x $20 (US) = _______________
  47.  
  48.  
  49. Media required (mark with X): _______________ 5.25" ______________ 3.5"
  50.  
  51.  
  52. Address to send to:    Roland Skinner
  53.                        RJS Software
  54.                        P.O. Box 14134
  55.                        Bredell
  56.                        1623
  57.                        Republic of South Africa
  58.  
  59. FAX Number: +27-(0)11-792-4874
  60.  
  61. Note - Credit card orders will not be processed without a signature.
  62.      - Orders by cheque or credit card are checked for clearance.
  63.